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DEVELOPMENT OF A DOMESTIC ENZYME IMMUNE TEST SYSTEM FOR DETECTION OF ANTI-HEV IGM IN BLOOD SERUM 国产酶免疫检测血清抗HEV-IGM系统的研制
Pub Date : 2023-06-01 DOI: 10.25298/2616-5546-2023-7-1-57-62
I. Zadora, S. Zhavoronok, V. Davydov, A. Babenka, L. Anisko, T. Rogacheva, V. V. Simirsky, A. Shcherban, N. V. Shchuka, Y. A. Mytko, G. Alatortseva, L. Lukhverchik, L. Nesterenko, V. Zverev
Background. Though the Republic of Belarus does not belong to countries endemic for viral hepatitis E, numerous studies have proved that hepatitis E virus (HEV) actively circulates among humans and animals. However, the circulation is latent that makes it difficult to diagnose the infection in a timely manner. Objective. To develop and evaluate the quality of a domestic ELISA test system for the detection of anti-HEI IgM. Material and methods. 96-well plates, recombinant proteins ORF2 and ORF3 of the 3rd HEV genotype, conjugate of monoclonal antibodies to human IgM with horseradish peroxidase, solutions for dilution of serums and conjugate containing bovine serum albumin. Results. The recommended concentrations of recombinant polypeptides ORF2 and ORF3 of hepatitis E virus genotype 3 for sorption are 2 and 1 μg/ml, respectively. The optimum dilution of the conjugate is 1:13 000. False positive and false negative results were not detected, sensitivity and specificity being at least 99%. The mean value for coefficient of variation within one plate is 6.4%, within two plates is 11.3%. Conclusions. The characteristics of the developed national test system comply with the recommended standards, thus indicating the possibility of its implementation into clinical laboratory diagnostics.
背景尽管白俄罗斯共和国不属于病毒性戊型肝炎流行国家,但大量研究证明,戊型肝炎病毒在人类和动物之间活跃传播。然而,循环是潜在的,这使得很难及时诊断感染。客观的开发并评价国产抗HEI IgM ELISA检测系统的质量。材料和方法。96孔板,第三HEV基因型的重组蛋白ORF2和ORF3,人IgM单克隆抗体与辣根过氧化物酶的缀合物,用于稀释血清的溶液和含有牛血清白蛋白的缀合体。后果戊型肝炎病毒基因型3的重组多肽ORF2和ORF3的推荐吸附浓度分别为2和1μg/ml。偶联物的最佳稀释度为1:13 000。未检测到假阳性和假阴性结果,敏感性和特异性至少为99%。一块钢板内变异系数的平均值为6.4%,两块钢板内为11.3%。所开发的国家检测系统的特性符合推荐标准,从而表明其在临床实验室诊断中实施的可能性。
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引用次数: 0
SURGICAL STRATEGY AND PREDICTION OF EARLY POSTOPERATIVE COMPLICATIONS AFTER PROXIMAL PANCREATECTOMY IN CHRONIC PANCREATITIS 慢性胰腺炎近端胰腺切除术后手术策略及早期并发症预测
Pub Date : 2023-06-01 DOI: 10.25298/2616-5546-2023-7-1-81-88
Y. Arlouski, A. Glyzdou, I. Salmin, A. Shchastniy
Background. The advances in surgical treatment of chronic pancreatitis (CP) have significantly reduced postoperative mortality rate, however, the number of deaths remains high. Thus, prevention and prediction of complications are regarded as a complex and important task in choosing optimal surgical strategy. Objective. To study early postoperative complications after proximal pancreatic resection in chronic pancreatitis; to determine surgical strategy in preoperative and postoperative stages to reduce the risk of and predict postoperative complications. Material and methods. From 2001 to 2019 on the basis of the Vitebsk Regional Clinical Hospital, 246 patients with CP and its complications were operated on, among them there were 223 (90.7%) men and 23 (9.3%) women. The mean age was 48(±6) years. Our study did not include patients who underwent Frey's operation and pancreatoduodenal resection due to their small number. Results. Of 246 operated patients, early postoperative complications occurred in 126 (51.2%) patients. Among them after the Beger’s operation - in 77 (31.2%) patients, after the Berne modification of the Beger’s operation - in 49 (20%) patients, respectively. Of the 126 patients with developed postoperative complications, repeated surgical interventions were performed in 50 (39.7%) patients - 35 (70%) patients after the Beger’s operation and 15 (30%) patients after the Berne modification of the Beger’s operation, respectively; in 76 (60, 3%) patients, postoperative complications were controlled by conservative measures. In order to manage early postoperative complications, various types of surgical interventions were performed. Conclusions. Patients with pancreatic calcification, virsungectasia, virsungolithiasis in combination with portal hypertension are more likely to develop early postoperative complications during the Beger’s operation, in comparison with the Berne modification of the Beger’s operation. In patients with pancreatic calcification, virsungectasia and virsungolithiasis in combination with portal hypertension, as well as in patients with pancreatic head cysts, it is advisable to perform the Berne modification of the Beger’s operation, it being technically simpler thus allowing to minimize the number of postoperative complications. When performing the Beger’s operation, as compared to the Berne modification of the Beger’s operation, there were no statistically significant differences in the total number of repeated interventions aimed to correct early postoperative complications, however, after the Beger’s operation, the complications were statistically significantly more often managed by minimally invasive intervention (p=0.005).
背景慢性胰腺炎(CP)外科治疗的进展显著降低了术后死亡率,但死亡人数仍然很高。因此,并发症的预防和预测被视为选择最佳手术策略的一项复杂而重要的任务。客观的研究慢性胰腺炎胰腺近端切除术后早期并发症;确定术前和术后阶段的手术策略,以降低和预测术后并发症的风险。材料和方法。从2001年到2019年,在维捷布斯克地区临床医院的基础上,246名CP及其并发症患者接受了手术,其中男性223人(90.7%),女性23人(9.3%)。平均年龄48(±6)岁。我们的研究不包括接受弗雷手术和胰十二指肠切除术的患者,因为他们的人数很少。后果246例手术患者中,术后早期并发症126例(51.2%)。其中贝格尔手术后77例(31.2%)患者,贝格尔手术伯尔尼改良后49例(20%)患者。在126名出现术后并发症的患者中,50名(39.7%)患者进行了重复手术干预,分别为Beger手术后的35名(70%)患者和Beger手术Berne改良术后的15名(30%)患者;76例(60.3%)患者术后并发症得到保守控制。为了控制术后早期并发症,进行了各种类型的手术干预。结论。与贝格尔手术的伯尔尼改良术相比,患有胰腺钙化、黄热病、黄热病合并门静脉高压的患者在贝格尔手术期间更有可能出现术后早期并发症。对于伴有门静脉高压的胰腺钙化、室氏管扩张和室氏管结石患者,以及胰头囊肿患者,建议对Beger手术进行Berne改良,这在技术上更简单,从而可以最大限度地减少术后并发症的数量。在进行Beger手术时,与Beger手术的Berne改良相比,旨在纠正术后早期并发症的重复干预总次数没有统计学上的显著差异,然而,在Beger手术后,在统计学上,微创介入治疗并发症的频率更高(p=0.005)。
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引用次数: 0
ASSESSMENT OF VACCINATION IMPACT ON HEPATITIS B EPIDEMIOLOGY IN THE REPUBLIC OF BELARUS 评估接种疫苗对白俄罗斯共和国乙型肝炎流行病学的影响
Pub Date : 2023-06-01 DOI: 10.25298/2616-5546-2023-7-1-48-56
V. Vysotskaya, N. Kolomiets, I. Glinskaya, O. Romanova, E. Gasich, E. Samoilovich
Integration of hepatitis B (HBV) vaccination into national immunization programs has resulted in a significant reduction in hepatitis B virus (HBV) transmission worldwide, and specifically in previously highly endemic countries. A key aspect of HBV elimination strategy is the administration of a birth dose followed by a further hepatitis B vaccination of newborns. Additional preventive measures include screening during pregnancy, administration of antivirals as well as the use of HB immunoglobulin. Despite a significant decrease in the number of HB cases, vaccination of adults, in particular those of high-risk groups, remains an important challenge. Objective. To evaluate the impact of vaccination strategies on HB epidemiology in the Republic of Belarus. Material and methods. HBV incidence in the Republic of Belarus has been estimated according to the data from state statistical reporting forms. The results were statistically processed using Statistica V.10.0 program (Statsoft, USA). Results. Over the period in question there has been noted a marked decrease in the incidence of acute and asymptomatic HBV forms (the rate (ТсН.) equals to -13,25% and -11,99% respectively), while the incidence of chronic hepatitis B (CHB) tends to increase (the rate (Тpr.) equals to +1,09%). Over the period of 2002-2022, CHB prevails in the etiological structure, constituting more than 70% of observations in the total structure of HB since 2018. HBV incidence pattern varies according to the regions. Currently, the leading cohort in the overall incidence is the population aged 30-49. The incidence rate of hepatitis B among individuals of this age cohort (320.57 per 100 thousand people) is 2.35 times higher than that of a 0-29-yearage cohort (136.50 per 100 thousand people) that is accounted for by a low level of preventive vaccination coverage (according to medical records), equal to 39.3% for the cohort aged 30-49. Scheduled vaccine prophylaxis introduced in 2000 has become the basis for the effective HB epidemiology surveillance in the Republic of Belarus. Conclusions. The period in question is characterized by both a marked decrease in the incidence of nosological HBV forms (the rate is 7.5%) and a moderate increase in the incidence of chronic hepatitis B (the rate (Тpr.) equals to +1,09%. Despite the undeniable progress and success of HB vaccination, it should be mentioned that an estimated over 65% of unvaccinated adult population may form a cluster for the potential spread of the virus.
将乙型肝炎(HBV)疫苗接种纳入国家免疫规划已导致乙型肝炎病毒(HBV)在世界范围内传播的显著减少,特别是在以前高度流行的国家。消除乙型肝炎病毒战略的一个关键方面是在新生儿进一步接种乙型肝炎疫苗后给予出生剂量。其他预防措施包括怀孕期间的筛查、抗病毒药物的使用以及HB免疫球蛋白的使用。尽管HB病例数量显著减少,但成人,特别是高危人群的疫苗接种仍然是一项重要挑战。目标。评估白俄罗斯共和国疫苗接种策略对乙肝流行病学的影响。材料和方法。白俄罗斯共和国乙型肝炎病毒发病率是根据国家统计报告表格的数据估计的。使用Statistica V.10.0程序(Statsoft, USA)对结果进行统计处理。结果。在此期间,急性和无症状乙型肝炎的发病率显著下降(发病率(ТсН.)分别为- 13.25%和- 11.99%),而慢性乙型肝炎(CHB)的发病率呈上升趋势(发病率(Тpr.)为+ 1.09%)。在2002-2022年期间,CHB在病因结构中占主导地位,占2018年以来HB总结构观察值的70%以上。HBV的发病模式因地区而异。目前,总发病率的主要人群是30-49岁的人群。该年龄组的乙肝发病率(每10万人320.57人)比0-29岁年龄组(每10万人136.50人)高2.35倍,这是由于预防接种覆盖率低(根据医疗记录),30-49岁年龄组的乙肝发病率为39.3%。2000年开始实行的定期疫苗预防已成为白俄罗斯共和国有效监测乙型肝炎流行病学的基础。结论。这一时期的特点是病源性乙型肝炎发病率显著下降(发病率为7.5%),慢性乙型肝炎发病率中度上升(发病率(Тpr.)为1.09%。尽管乙肝疫苗接种取得了不可否认的进展和成功,但应该提到的是,估计超过65%的未接种疫苗的成年人口可能形成病毒潜在传播的聚集性。
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引用次数: 0
CLINICAL AND LABORATORY CHARACTERISTICS OF LIVER DAMAGE IN COVID-19 COVID-19肝损害的临床和实验室特征
Pub Date : 2023-06-01 DOI: 10.25298/2616-5546-2023-7-1-63-66
S. A. Chernyak
Background. Having its multisystemic effect СOVID-19 leads to liver disfunction. Objective. To assess the functional state of the liver in patients with COVID-19 during the periods of circulation of different SARS-CoV 2 strains. Material and methods. The object of the study was 180 patients with COVID-19 who were hospitalized at Grodno Regional Infectious Diseases Clinical Hospital. The patients were divided into two groups: the 1st group (n=51) - those examined during the circulation of the Omicron strain (2022), the 2nd (n=129) – the patients who were treated over 2020-2021 (during the circulation of previous strains). The laboratory analysis included the assessment of biochemical and sonographic parameters. Results. In the first group, dyspeptic syndrome, hyperbilirubinemia and hypoalbuminemia were more often recorded. The patients of the second group had more pronounced manifestations of severe respiratory failure alongside with significantly more pronounced hyperenzymemia according to aspartate aminotransferase (AST) level. Conclusions. Hyperbilirubinemia and hypoalbuminemia, being significantly more common during the circulation of the Omicron strain, may be regarded as a manifestation of acute mixed-etiology reactive hepatitis. The predominance of hyperenzymemia due to AST during the circulation of other strains may be accounted for by the cytopathic effect of the virus and drug-induced liver damage.
背景具有多系统作用的СOVID-19会导致肝脏功能紊乱。客观的评估新冠肺炎患者在不同SARS-CoV2毒株循环期间的肝脏功能状态。材料和方法。研究对象是在格罗德诺地区传染病临床医院住院的180名新冠肺炎患者。患者被分为两组:第一组(n=51)——在奥密克戎毒株循环期间(2022年)接受检查的患者,第二组(n=129)——在2020-2021年期间(在先前毒株循环期间)接受治疗的患者。实验室分析包括对生化和超声参数的评估。后果在第一组中,消化不良综合征、高胆红素血症和低白蛋白血症更常见。根据天冬氨酸转氨酶(AST)水平,第二组患者有更明显的严重呼吸衰竭表现,同时伴有更明显的高酶血症。结论。高胆红素血症和低白蛋白血症在奥密克戎毒株的循环过程中更为常见,可被视为急性混合病因反应性肝炎的一种表现。在其他菌株的循环过程中,AST引起的高酶血症的主要原因可能是病毒的细胞病变作用和药物诱导的肝损伤。
{"title":"CLINICAL AND LABORATORY CHARACTERISTICS OF LIVER DAMAGE IN COVID-19","authors":"S. A. Chernyak","doi":"10.25298/2616-5546-2023-7-1-63-66","DOIUrl":"https://doi.org/10.25298/2616-5546-2023-7-1-63-66","url":null,"abstract":"Background. Having its multisystemic effect СOVID-19 leads to liver disfunction. Objective. To assess the functional state of the liver in patients with COVID-19 during the periods of circulation of different SARS-CoV 2 strains. Material and methods. The object of the study was 180 patients with COVID-19 who were hospitalized at Grodno Regional Infectious Diseases Clinical Hospital. The patients were divided into two groups: the 1st group (n=51) - those examined during the circulation of the Omicron strain (2022), the 2nd (n=129) – the patients who were treated over 2020-2021 (during the circulation of previous strains). The laboratory analysis included the assessment of biochemical and sonographic parameters. Results. In the first group, dyspeptic syndrome, hyperbilirubinemia and hypoalbuminemia were more often recorded. The patients of the second group had more pronounced manifestations of severe respiratory failure alongside with significantly more pronounced hyperenzymemia according to aspartate aminotransferase (AST) level. Conclusions. Hyperbilirubinemia and hypoalbuminemia, being significantly more common during the circulation of the Omicron strain, may be regarded as a manifestation of acute mixed-etiology reactive hepatitis. The predominance of hyperenzymemia due to AST during the circulation of other strains may be accounted for by the cytopathic effect of the virus and drug-induced liver damage.","PeriodicalId":34878,"journal":{"name":"Gepatologiia i gastroenterologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49061190","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
EXPERIENCE IN THE TREATMENT OF LIVER ECHINOCOCCOSIS 肝棘球蚴病的治疗体会
Pub Date : 2023-06-01 DOI: 10.25298/2616-5546-2023-7-1-67-73
R. Shyla, E. Mogilevets, K. S. Belyuk, I. G. Zhuk, O. S. Soroka, A. A. Denischik
Background. Liver echinococcosis is a parasitic liver disease caused by Echinococcus granulosus. The choice of surgical strategy for this pathology remains challenging. Objective. To analyze the received surgical outcomes in patients with liver echinococcosis. Material and methods. From 2012 to 2022, 27 patients with liver echinococcosis were treated in “Grodno University Clinic”. All patients underwent an extensive diagnostic evaluation that included a complex of laboratory and instrumental diagnostic methods as well as surgery. Results. All the patients underwent resections, including laparoscopic ones (25.9%). No post-operative complications and fatal outcomes were recorded. Conclusions. Patients with liver echinococcosis should be referred to specialized regional or republican hospitals. It is necessary that patients should undergo CT of the abdominal and chest cavities as well of the brain in search for additional foci. Preference should be given to minimally invasive surgical techniques. Negative serology test to echinococcosis does not rule out the presence of a parasite-induced lesions in a patient. The technique of total vascular isolation during surgery is preferable for resection of liver cysts with invasive growth into nearby large vessels.
背景肝棘球蚴病是由细粒棘球蚴引起的一种寄生性肝病。这种病理的手术策略的选择仍然具有挑战性。客观的分析肝棘球蚴病患者的手术疗效。材料和方法。2012年至2022年,27名肝棘球蚴病患者在“格罗德诺大学诊所”接受治疗。所有患者都接受了广泛的诊断评估,包括复杂的实验室和仪器诊断方法以及手术。后果所有患者均接受了切除术,包括腹腔镜切除术(25.9%)。没有记录到术后并发症和致命结果。结论。肝棘球蚴病患者应转诊至地区或共和国的专科医院。有必要对患者的腹腔和胸腔以及大脑进行CT检查,以寻找其他病灶。应优先考虑微创手术技术。棘球蚴病血清学检测呈阴性并不排除患者体内存在寄生虫引起的病变。手术中的全血管隔离技术更适合切除侵入性生长到附近大血管的肝囊肿。
{"title":"EXPERIENCE IN THE TREATMENT OF LIVER ECHINOCOCCOSIS","authors":"R. Shyla, E. Mogilevets, K. S. Belyuk, I. G. Zhuk, O. S. Soroka, A. A. Denischik","doi":"10.25298/2616-5546-2023-7-1-67-73","DOIUrl":"https://doi.org/10.25298/2616-5546-2023-7-1-67-73","url":null,"abstract":"Background. Liver echinococcosis is a parasitic liver disease caused by Echinococcus granulosus. The choice of surgical strategy for this pathology remains challenging. Objective. To analyze the received surgical outcomes in patients with liver echinococcosis. Material and methods. From 2012 to 2022, 27 patients with liver echinococcosis were treated in “Grodno University Clinic”. All patients underwent an extensive diagnostic evaluation that included a complex of laboratory and instrumental diagnostic methods as well as surgery. Results. All the patients underwent resections, including laparoscopic ones (25.9%). No post-operative complications and fatal outcomes were recorded. Conclusions. Patients with liver echinococcosis should be referred to specialized regional or republican hospitals. It is necessary that patients should undergo CT of the abdominal and chest cavities as well of the brain in search for additional foci. Preference should be given to minimally invasive surgical techniques. Negative serology test to echinococcosis does not rule out the presence of a parasite-induced lesions in a patient. The technique of total vascular isolation during surgery is preferable for resection of liver cysts with invasive growth into nearby large vessels.","PeriodicalId":34878,"journal":{"name":"Gepatologiia i gastroenterologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49078611","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
A CLINICAL CASE OF BULEVIRTIDE THERAPY FOR CHRONIC HDV-INFECTION 布列维肽治疗慢性HDV感染1例
Pub Date : 2023-06-01 DOI: 10.25298/2616-5546-2023-7-1-89-92
N. A. Illarionova, S. S. Sleptsova
Background. The Republic of Sakha (Yakutia) is an endemic region for chronic hepatitis D, where the detection rate of antibodies to the delta virus is 35% [3]. The urgency of the problem of HDV infection is also determined by its aggressive and rapidly progressive course. In 2019, Bulevirtide, a drug for the treatment of chronic delta hepatitis, was registered in Russia. Three randomized trials showed a high rate of virological, biochemical response, as well as good tolerability and safety. Objective – to evaluate the efficacy and safety of Bulevirtide in the treatment of chronic HDV infection. Material and methods. A clinical case of a patient L. suffering from a chronic form of HDV infection receiving antiviral therapy is presented. Results. Bulevirtide demonstrated high efficacy, as evidenced by the development of a virological response during the first 14 weeks of therapy and a decrease in HDV RNA to an undetectable level within 29. Conclusions. It is necessary to widely introduce Bulevirtide for the treatment of patients with chronic delta hepatitis due to its high efficacy and safety.
背景萨哈共和国(雅库特)是慢性丙型肝炎的流行地区,德尔塔病毒抗体的检测率为35%[3]。HDV感染问题的紧迫性也由其侵袭性和快速进展的过程决定。2019年,治疗慢性德尔塔型肝炎的药物Bulevitide在俄罗斯注册。三项随机试验显示了高的病毒学和生化反应率,以及良好的耐受性和安全性。目的:评价博韦肽治疗慢性HDV感染的疗效和安全性。材料和方法。介绍了一例患有慢性HDV感染的患者L.接受抗病毒治疗的临床病例。后果在治疗的前14周出现病毒学反应,HDV RNA在29周内降至检测不到的水平,证明了布韦肽具有很高的疗效。结论。布列韦肽治疗慢性德尔塔型肝炎疗效高、安全性好,有必要广泛应用。
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引用次数: 0
CHARACTERISTICS AND VISUALIZATION OF PHAGOCYTIC CELLS OF THE IMMUNITY SYSTEM IN LIVER INFLAMMATION 肝脏炎症免疫系统吞噬细胞的特征及可视化
Pub Date : 2023-06-01 DOI: 10.25298/2616-5546-2023-7-1-28-36
V. Andreev, V. Tsyrkunov, N. Prokopchik
Chronic liver disease is a complex multi-stage process involving many immune and non-immune cells. Understanding the pathology of many liver diseases requires knowledge of the cell biology of phagocytes. The review summarizes our current perception of the role of phagocyte cells of the innate immune system in chronic inflammation, with an emphasis on their interaction with inflammatory participants. A better understanding of the role of the cells in the innate immune response may serve as the basis for the development of new immunotherapeutic approaches for the treatment of aseptic and infectious liver diseases. The purpose of the review is to visualize and summarize the current results of the study of the functions of professional liver phagocytes and their role in initiating the immune response in relation to inflammatory markers. Visualization of various cell types, in particular, professional phagocytes, was carried out using semi-thin sections prepared from specially fixed liver biopsies which made it possible to estimate their number and obtain data on changes in the surrounding tissue in pathological conditions. In addition to this method, the electron microscopic method made it possible to assess the state of intracellular structures. The review is supplemented by the results of our own studies obtained using these methods, with a special focus on phagocytes responsible for innate immunity.
慢性肝病是一个复杂的多阶段过程,涉及许多免疫和非免疫细胞。了解许多肝脏疾病的病理需要了解吞噬细胞的细胞生物学。这篇综述总结了我们目前对先天免疫系统吞噬细胞在慢性炎症中的作用的认识,重点是它们与炎症参与者的相互作用。更好地了解细胞在先天免疫反应中的作用,可以作为开发新的免疫治疗方法的基础,用于治疗无菌性和感染性肝病。回顾的目的是可视化和总结目前的研究结果,专业肝吞噬细胞的功能和它们在启动炎症标志物相关的免疫反应中的作用。各种细胞类型的可视化,特别是专业吞噬细胞,使用由特殊固定的肝活组织切片制备的半薄切片进行,这使得可以估计它们的数量并获得病理条件下周围组织变化的数据。除了这种方法,电子显微镜的方法使评估细胞内结构的状态成为可能。本综述还补充了我们自己使用这些方法获得的研究结果,特别关注负责先天免疫的吞噬细胞。
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引用次数: 0
HEREDITARY UNCONJUGATED HYPERBILIRUBINEMIA 遗传性非结合性高胆红素血症
Pub Date : 2023-06-01 DOI: 10.25298/2616-5546-2023-7-1-15-20
N. Silivontchik, T. N. Yakubchyk, O. A. Zhigaltsova-Kuchinskaya
Congenital hereditary non-conjugate hyperbilirubinemias include Gilbert’s syndrome, Crigler-Najjar type 1 and Crigler-Najjar type 2 syndromes (or Arias’ disease). They are caused by a hereditary deficiency of the enzyme - bilirubinuridine-5’-diphosphate glucuronosyltransferase (UGT1A1), involved in the glucuronization of bilirubin. The enzyme deficiency is due to mutations in the UGT1A1 gene, which provides UGT1A1 activity. Complete or almost complete loss of (Crigler-Najjar syndrome type 1) or decreased UGT1A1 activity (Gilbert’s syndrome and Crigler-Najjar syndrome type 2) lead to impaired conversion of bilirubin in the liver with the accumulation of unconjugated bilirubin in the blood. Syndromes are distinguished by the level of bilirubin in blood plasma, the reaction to the introduction of phenobarbital, the presence or absence of bilirubin glucuronides in bile.
先天性遗传性非结合型高胆红素血症包括吉尔伯特综合征、1型Crigler-Najjar和2型Crigler Najjar综合征(或Arias病)。它们是由胆红素5’-二磷酸葡萄糖醛酸基转移酶(UGT1A1)的遗传缺陷引起的,该酶参与胆红素的葡萄糖醛酸化。酶缺乏是由于提供UGT1A1活性的UGT1A1基因突变引起的。完全或几乎完全丧失(1型Crigler-Najjar综合征)或UGT1A1活性降低(Gilbert综合征和2型Crigler Najjar综合症)会导致肝脏中胆红素转化受损,并在血液中积聚未结合的胆红素。根据血浆中胆红素的水平、对苯巴比妥的反应、胆汁中是否存在胆红素葡萄糖醛酸苷来区分综合征。
{"title":"HEREDITARY UNCONJUGATED HYPERBILIRUBINEMIA","authors":"N. Silivontchik, T. N. Yakubchyk, O. A. Zhigaltsova-Kuchinskaya","doi":"10.25298/2616-5546-2023-7-1-15-20","DOIUrl":"https://doi.org/10.25298/2616-5546-2023-7-1-15-20","url":null,"abstract":"Congenital hereditary non-conjugate hyperbilirubinemias include Gilbert’s syndrome, Crigler-Najjar type 1 and Crigler-Najjar type 2 syndromes (or Arias’ disease). They are caused by a hereditary deficiency of the enzyme - bilirubinuridine-5’-diphosphate glucuronosyltransferase (UGT1A1), involved in the glucuronization of bilirubin. The enzyme deficiency is due to mutations in the UGT1A1 gene, which provides UGT1A1 activity. Complete or almost complete loss of (Crigler-Najjar syndrome type 1) or decreased UGT1A1 activity (Gilbert’s syndrome and Crigler-Najjar syndrome type 2) lead to impaired conversion of bilirubin in the liver with the accumulation of unconjugated bilirubin in the blood. Syndromes are distinguished by the level of bilirubin in blood plasma, the reaction to the introduction of phenobarbital, the presence or absence of bilirubin glucuronides in bile.","PeriodicalId":34878,"journal":{"name":"Gepatologiia i gastroenterologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48111075","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
EFFECT OF MEROPENEM AND IMICENEM ON MICROBIOCENOSIS AND MORPHOLOGY OF THE SMALL INTESTINE IN RATS 美罗培南和亚胺烯对大鼠小肠微生物群落和形态的影响
Pub Date : 2023-06-01 DOI: 10.25298/2616-5546-2023-7-1-43-47
V. М. Sheybak, A. V. Lemesh, I. Nikolaeva, R. Yakubtsevich, O. Ostrovskaya
Background. Gut microbiota plays an important role in the human body, antimicrobial drugs intake being one of the main factors affecting microbiota composition. Antibiotics suppress normal intestinal microflora allowing for the growth and development of pathogenic flora. Objective. To study the effect of meropenem and imicenem on the microbiocenosis and morphology of the small intestine in rats. Material and methods. In an experiment on rats, we analysed the microbiocenosis of the large intestine after intraperitoneal administration of meropenem, imicinem and 0.9% NaCl, as well as examined samples of the small intestine. Results. In a comparative analysis of the control group with the meropenem and imicinem groups, there has been noted a decrease in the number of anaerobes in the meropenem group (8.6±0.14, p<0.05) as compared with the control group (9.4±0.22, p<0 .05) and the imicinem group (9.4±0.40, p<0.05); the number of bifidobacteria decreased in the meropenem group (8.1±0.16, p<0.05) in contrast to the control group (9.2±0.25, p<0.05) and the imicinem group (9.2±0.41, p<0.05). When compared with meropenem (3.8±0.44, p<0.05), imicinem (4.9±0.20, p<0.05) led to a greater growth of spore-forming anaerobes. In animals of the imicinem group, the histostructure of the jejunal mucosa was similar to the control group, while in the meropenem group, inflammatory changes in the stroma of the villi of the jejunal mucosa were observed. Conclusions. In a comparative analysis of carbapenem activity, it has been determined that these antibiotics both have a significant effect on the microbiocenosis of the large intestine and affect the mucous wall of the small intestine. These should be taken into account by clinicians in order to improve the effectiveness and safety of antibiotic therapy.
背景肠道微生物群在人体中起着重要作用,抗菌药物的摄入是影响微生物群组成的主要因素之一。抗生素抑制正常肠道菌群,从而促进病原菌群的生长发育。客观的研究美罗培南和亚胺烯对大鼠小肠微生物群落和形态的影响。材料和方法。在一项大鼠实验中,我们分析了腹膜内给药美罗培南、亚胺西南和0.9%氯化钠后大肠的微生物群落,并检查了小肠样本。后果在对照组与美罗培南和亚胺西南组的比较分析中,与对照组(9.4±0.22,p<0.05)和亚胺西宁组(9.4士0.40,p>0.05)相比,美罗培南组的厌氧菌数量减少了(8.6±0.14,p=0.05);美罗培南组的双歧杆菌数量(8.1±0.16,p<0.05)与对照组(9.2±0.25,p<0.05)和亚胺西南组(9.2士0.41,p<0.05)相比有所减少。在亚胺西南组的动物中,空肠粘膜的组织结构与对照组相似,而在美罗培南组中,观察到空肠粘膜绒毛间质的炎症变化。结论。在碳青霉烯活性的比较分析中,已经确定这些抗生素对大肠的微生物群落有显著影响,并影响小肠的粘膜。临床医生应该考虑这些因素,以提高抗生素治疗的有效性和安全性。
{"title":"EFFECT OF MEROPENEM AND IMICENEM ON MICROBIOCENOSIS AND MORPHOLOGY OF THE SMALL INTESTINE IN RATS","authors":"V. М. Sheybak, A. V. Lemesh, I. Nikolaeva, R. Yakubtsevich, O. Ostrovskaya","doi":"10.25298/2616-5546-2023-7-1-43-47","DOIUrl":"https://doi.org/10.25298/2616-5546-2023-7-1-43-47","url":null,"abstract":"Background. Gut microbiota plays an important role in the human body, antimicrobial drugs intake being one of the main factors affecting microbiota composition. Antibiotics suppress normal intestinal microflora allowing for the growth and development of pathogenic flora. Objective. To study the effect of meropenem and imicenem on the microbiocenosis and morphology of the small intestine in rats. Material and methods. In an experiment on rats, we analysed the microbiocenosis of the large intestine after intraperitoneal administration of meropenem, imicinem and 0.9% NaCl, as well as examined samples of the small intestine. Results. In a comparative analysis of the control group with the meropenem and imicinem groups, there has been noted a decrease in the number of anaerobes in the meropenem group (8.6±0.14, p<0.05) as compared with the control group (9.4±0.22, p<0 .05) and the imicinem group (9.4±0.40, p<0.05); the number of bifidobacteria decreased in the meropenem group (8.1±0.16, p<0.05) in contrast to the control group (9.2±0.25, p<0.05) and the imicinem group (9.2±0.41, p<0.05). When compared with meropenem (3.8±0.44, p<0.05), imicinem (4.9±0.20, p<0.05) led to a greater growth of spore-forming anaerobes. In animals of the imicinem group, the histostructure of the jejunal mucosa was similar to the control group, while in the meropenem group, inflammatory changes in the stroma of the villi of the jejunal mucosa were observed. Conclusions. In a comparative analysis of carbapenem activity, it has been determined that these antibiotics both have a significant effect on the microbiocenosis of the large intestine and affect the mucous wall of the small intestine. These should be taken into account by clinicians in order to improve the effectiveness and safety of antibiotic therapy.","PeriodicalId":34878,"journal":{"name":"Gepatologiia i gastroenterologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42068743","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
EVIDENCE-BASED MEDICINE: OBVIOUS BENEFITS AND HIDDEN DRAWBACKS 循证医学:有利有弊
Pub Date : 2023-06-01 DOI: 10.25298/2616-5546-2023-7-1-6-14
Yakusevich V. V.
The article covers basic information on the comparative evaluation of drugs efficacy and safety from the standpoint of both clinical experience and evidence-based medicine. It is emphasized that despite all its advantages evidencebased medicine does not contradict the "opinion-based medicine". There have been presented the basic rules for conducting randomized clinical trials referred to as the most modern method of evidence collection. The main criteria of evidence are described. At the same time, it is emphasized that evidence-based medicine has its drawbacks. The main of them - is inability to transfer the results obtained in a clinical trial to the treatment of all patients with the disease in question. The principle of comparing results between clinical trial and real-world data (RWD / RWE) is described – the project RCT DUPLICATE. The author’s opinion on the main drawbacks in conducting and reporting clinical trials is presented. A number of ethical issues in clinical trials is evaluated. The author claims that the selection of optimal treatment strategy for a particular patient should rely on combination of evidence-based medicine, clinical experience, and historical data as well.
本文涵盖了从临床经验和循证医学的角度对药物疗效和安全性进行比较评估的基本信息。强调证据医学尽管有诸多优点,但与“观点医学”并不矛盾。已经提出了进行随机临床试验的基本规则,被称为最现代的证据收集方法。介绍了证据的主要标准。同时强调循证医学也有其弊端。其中最主要的问题是无法将临床试验的结果用于治疗所有有问题的患者。描述了临床试验和真实世界数据(RWD/RWE)之间比较结果的原理——RCT DUPLICATE项目。作者对临床试验进行和报告的主要缺点提出了看法。对临床试验中的一些伦理问题进行了评估。作者声称,为特定患者选择最佳治疗策略应结合循证医学、临床经验和历史数据。
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Gepatologiia i gastroenterologiia
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