Pub Date : 2023-01-01DOI: 10.32000/2072-1757-2023-4-23-29
S. L. Morozov, T. S. Kursova, O. R. Piruzieva, V. Dlin
In pediatric nephrology, idiopathic nephrotic syndrome is the most common glomerular disease. It is now known that about 70% of children with idiopathic nephrotic syndrome develop relapses of the disease, while about 10% of patients are resistant to steroid therapy. In recent decades, calcineurin inhibitors, cyclosporine A and tacrolimus have been used in the treatment of steroid-resistant and steroid-dependent nephrotic syndrome as the first line of immunosuppressive therapy, forming the basis of the treatment of nephrotic syndrome, with more than 70% of patients achieving complete or partial remission of the disease with a favorable long-term prognosis for kidney function. This review discusses the mechanisms of calcineurin inhibitors action and their advantages and disadvantages. Varied therapeutic responses to calcineurin inhibitors prompt further investigation of population pharmacokinetics and pharmacodynamics in order to subsequently consider and possibly develop personalized treatment regimens through the use of therapeutic drug monitoring.
{"title":"Calcineurin inhibitors in the treatment of primary nephrotic syndrome in children","authors":"S. L. Morozov, T. S. Kursova, O. R. Piruzieva, V. Dlin","doi":"10.32000/2072-1757-2023-4-23-29","DOIUrl":"https://doi.org/10.32000/2072-1757-2023-4-23-29","url":null,"abstract":"In pediatric nephrology, idiopathic nephrotic syndrome is the most common glomerular disease. It is now known that about 70% of children with idiopathic nephrotic syndrome develop relapses of the disease, while about 10% of patients are resistant to steroid therapy. In recent decades, calcineurin inhibitors, cyclosporine A and tacrolimus have been used in the treatment of steroid-resistant and steroid-dependent nephrotic syndrome as the first line of immunosuppressive therapy, forming the basis of the treatment of nephrotic syndrome, with more than 70% of patients achieving complete or partial remission of the disease with a favorable long-term prognosis for kidney function. This review discusses the mechanisms of calcineurin inhibitors action and their advantages and disadvantages. Varied therapeutic responses to calcineurin inhibitors prompt further investigation of population pharmacokinetics and pharmacodynamics in order to subsequently consider and possibly develop personalized treatment regimens through the use of therapeutic drug monitoring.","PeriodicalId":9821,"journal":{"name":"中国实用医药","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79219937","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}
Pub Date : 2023-01-01DOI: 10.32000/2072-1757-2023-3-79-81
E. R. Kadyseva, L. Kulagina, V. Khaziakhmetova
The article presents the results of the study of safety of oral anticoagulants (OACs) use in trauma patients.Venous thromboembolic complications (VTEC) after surgery are among the most common indications for prescribing direct oral anticoagulants (OACs) in elderly patients, the treatment of which can cause serious problems and is associated with age-related characteristics of the organism. The purpose — to study the safety of using oral anticoagulants (OACs) use in a trauma hospital. Material and methods. A retrospective analysis was performed of 120 medical records of inpatients receiving oral anticoagulants to prevent blood clots after reconstructive surgery for bone fractures.In the study, 2 groups were considered: group 1 (without violations of hemostasis) — 50 people, aged 54.6 ± 18.0, group 2 (with impaired hemostasis) — 70 people, aged 61.3 ± 21.5. Conclusions. There is a cause-and-effect relationship between a violation of hemostasis indicators (mainly an increase in APTT) and risk factors.
{"title":"Analysis of rationality of pharmacotherapy with oral anticoagulants in a trauma hospital","authors":"E. R. Kadyseva, L. Kulagina, V. Khaziakhmetova","doi":"10.32000/2072-1757-2023-3-79-81","DOIUrl":"https://doi.org/10.32000/2072-1757-2023-3-79-81","url":null,"abstract":"The article presents the results of the study of safety of oral anticoagulants (OACs) use in trauma patients.Venous thromboembolic complications (VTEC) after surgery are among the most common indications for prescribing direct oral anticoagulants (OACs) in elderly patients, the treatment of which can cause serious problems and is associated with age-related characteristics of the organism. The purpose — to study the safety of using oral anticoagulants (OACs) use in a trauma hospital. Material and methods. A retrospective analysis was performed of 120 medical records of inpatients receiving oral anticoagulants to prevent blood clots after reconstructive surgery for bone fractures.In the study, 2 groups were considered: group 1 (without violations of hemostasis) — 50 people, aged 54.6 ± 18.0, group 2 (with impaired hemostasis) — 70 people, aged 61.3 ± 21.5. Conclusions. There is a cause-and-effect relationship between a violation of hemostasis indicators (mainly an increase in APTT) and risk factors.","PeriodicalId":9821,"journal":{"name":"中国实用医药","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87375172","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}
Pub Date : 2023-01-01DOI: 10.32000/2072-1757-2023-2-54-57
L. Ivanova, E. Akulinushkina, S. Lapshina, D. Abdulganieva
Seronegative spondyloarthritis (SpA) (psoriatic arthritis (PsA) and axial spondyloarthritis (AxSpA)), inflammatory bowel disease (IBD) and psoriasis form a group of immunoinflammatory diseases (IIDs). The increased risk of developing IBD in patients with IIDs is known and, on the contrary, the risk of skeletal-muscle IIDs in patients with IBD was demonstrated. This indicates the necessity of early diagnosis of IBD in patients with SpA. In connection with this, a screening tool «Universal questionnaire for identifying signs of immunoinflammatory diseases» was developed and put into practice. The article shows the results of the «Universal questionnaire for IIDs» use in rheumatology practice by 140 patients with SpA. It was found that 17.2% patients with PsA and 20.8% with AxSpA required further exclusion of IBD. The need to exclude IBD was equally frequent in patients with PsA and AxSpA. Clinical and laboratory parameters in groups with the alleged IBD did not significantly differ from those in other patients, which confirms the need to introduce the «Universal questionnaire» into the practice for the purpose of early diagnosis of combined IIDs.
{"title":"Early diagnosis of inflammatory bowel diseases in patients with spondyloarthritis","authors":"L. Ivanova, E. Akulinushkina, S. Lapshina, D. Abdulganieva","doi":"10.32000/2072-1757-2023-2-54-57","DOIUrl":"https://doi.org/10.32000/2072-1757-2023-2-54-57","url":null,"abstract":"Seronegative spondyloarthritis (SpA) (psoriatic arthritis (PsA) and axial spondyloarthritis (AxSpA)), inflammatory bowel disease (IBD) and psoriasis form a group of immunoinflammatory diseases (IIDs). The increased risk of developing IBD in patients with IIDs is known and, on the contrary, the risk of skeletal-muscle IIDs in patients with IBD was demonstrated. This indicates the necessity of early diagnosis of IBD in patients with SpA. In connection with this, a screening tool «Universal questionnaire for identifying signs of immunoinflammatory diseases» was developed and put into practice. The article shows the results of the «Universal questionnaire for IIDs» use in rheumatology practice by 140 patients with SpA. It was found that 17.2% patients with PsA and 20.8% with AxSpA required further exclusion of IBD. The need to exclude IBD was equally frequent in patients with PsA and AxSpA. Clinical and laboratory parameters in groups with the alleged IBD did not significantly differ from those in other patients, which confirms the need to introduce the «Universal questionnaire» into the practice for the purpose of early diagnosis of combined IIDs.","PeriodicalId":9821,"journal":{"name":"中国实用医药","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84340429","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}
Pub Date : 2023-01-01DOI: 10.32000/2072-1757-2023-4-47-54
L. Z. Afandieva, D. D. Gaynetdinova
Cerebral palsy (CP) is a group of persistent motor and postural disorders that cause activity limitations, which are explained by non-progressive disorders in the developing brain [1]. Inflammation is detailed in the pathogenesis of most perinatal brain injuries, which contributes to the risk of cerebral palsy, including neonatal stroke, preterm birth, birth asphyxia, and infection [2, 3]. Systematic reviews of the clinical literature now support an association between higher levels of circulating pro-inflammatory mediators and the diagnosis of cerebral palsy, especially in prematurity [4]. However, the duration and extent of this inflammation, as well as the consequences for children with cerebral palsy, remain unclear. Inflammation in cerebral palsy may consist in a change in the cytokine status [4]; altered immune response [5]; adaptive immune changes, including the distribution and function of T- and B-cells [6], as well as other genetic and non-genetic changes in signaling pathways [7]. Inflammation following perinatal brain injury is commonly reported to change over time, between the acute and chronic phases of injury [8]. However, persistent inflammation (i.e., inflammation lasting months to years after the primary injury phase) has been postulated to have detrimental effects on the brain and may contribute to severe forms of the disease. This is supported by the persistent inflammation hypothesis, also known as programming effects, whereby prenatal, antenatal, or neonatal pro-inflammatory cytokines induce inflammation that contributes to long-term cytokine dysregulation [9]. The study in children with an early residual stage of cerebral palsy demonstrated the relationship between the functional level on the GMFCS scale (Gross Motor Function Classification System) and some indicators of immune status.
{"title":"Gross motor functions and immune parameters in children with spastic cerebral palsy: is there a link?","authors":"L. Z. Afandieva, D. D. Gaynetdinova","doi":"10.32000/2072-1757-2023-4-47-54","DOIUrl":"https://doi.org/10.32000/2072-1757-2023-4-47-54","url":null,"abstract":"Cerebral palsy (CP) is a group of persistent motor and postural disorders that cause activity limitations, which are explained by non-progressive disorders in the developing brain [1]. Inflammation is detailed in the pathogenesis of most perinatal brain injuries, which contributes to the risk of cerebral palsy, including neonatal stroke, preterm birth, birth asphyxia, and infection [2, 3]. Systematic reviews of the clinical literature now support an association between higher levels of circulating pro-inflammatory mediators and the diagnosis of cerebral palsy, especially in prematurity [4]. However, the duration and extent of this inflammation, as well as the consequences for children with cerebral palsy, remain unclear. Inflammation in cerebral palsy may consist in a change in the cytokine status [4]; altered immune response [5]; adaptive immune changes, including the distribution and function of T- and B-cells [6], as well as other genetic and non-genetic changes in signaling pathways [7]. Inflammation following perinatal brain injury is commonly reported to change over time, between the acute and chronic phases of injury [8]. However, persistent inflammation (i.e., inflammation lasting months to years after the primary injury phase) has been postulated to have detrimental effects on the brain and may contribute to severe forms of the disease. This is supported by the persistent inflammation hypothesis, also known as programming effects, whereby prenatal, antenatal, or neonatal pro-inflammatory cytokines induce inflammation that contributes to long-term cytokine dysregulation [9]. The study in children with an early residual stage of cerebral palsy demonstrated the relationship between the functional level on the GMFCS scale (Gross Motor Function Classification System) and some indicators of immune status.","PeriodicalId":9821,"journal":{"name":"中国实用医药","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73074055","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}
Pub Date : 2023-01-01DOI: 10.32000/2072-1757-2023-4-108-112
L. S. Efremova, L. V. Vasilieva, E. Gosteva
The purpose — to study the association of lipoprotein-associated phospholipase A2 (LP-PLA2) inflammatory biomarkers and tumor necrosis factor-alpha (TNF-α) with indicators of carbohydrate and lipid metabolism in the progression of chronic heart failure with moderately reduced ejection fraction (HFmrEF) in patients with diabetes mellitus (DM). Material and methods. 78 patients with established diagnosis of DM and HFmrEF (EF = 41–49%), functional class (FC) of CHF I and II according to NYHA were examined. The patients underwent examination of carbohydrate and lipid metabolism, serum levels of LP-PLA2 and TNF-a. Two groups of patients were formed: the 1st group — patients with HFmrEF and DM who had myocardial infarction (MI), 37 people (47.4%), the 2nd group — patients with HFmrEFand DM, 41 people (52.6%). Results. An increase in the content of LP-PLA2 and TNF-a with an increase in CHF FC was revealed. In the 1st group, the levels of inflammation biomarkers, insulin, HOMA-IR, total cholesterol, low density lipoproteins significantly exceeded those in the 2nd group. A positive correlation was found between the levels of LP-PLA2 and TNF-a and the parameters of carbohydrate and lipid metabolism. Conclusion. The progression of DM and HFmrEF is accompanied by an increase in chronic inflammation and an increase in the content of Lp-PLA2 and TNF-a with an increase in CHF FC. The association of elevated levels of inflammatory biomarkers with carbohydrate and lipid metabolism is an additional factor of HFmrEF progression in patients with DM. An increase in the serum levels of inflammatory biomarkers in patients with HFmrEF and DM who underwent MI, compared with patients with HFmrEF and DM, makes it possible to use LP-PLA2 and TNF-a for diagnosing complications in patients with DM and HFmrEF.
{"title":"Interaction between inflammatory biomarkers and carbohydrate and lipid metabolism in patients with diabetes mellitus and chronic heart failure with moderately reduced ejection fraction","authors":"L. S. Efremova, L. V. Vasilieva, E. Gosteva","doi":"10.32000/2072-1757-2023-4-108-112","DOIUrl":"https://doi.org/10.32000/2072-1757-2023-4-108-112","url":null,"abstract":"The purpose — to study the association of lipoprotein-associated phospholipase A2 (LP-PLA2) inflammatory biomarkers and tumor necrosis factor-alpha (TNF-α) with indicators of carbohydrate and lipid metabolism in the progression of chronic heart failure with moderately reduced ejection fraction (HFmrEF) in patients with diabetes mellitus (DM). Material and methods. 78 patients with established diagnosis of DM and HFmrEF (EF = 41–49%), functional class (FC) of CHF I and II according to NYHA were examined. The patients underwent examination of carbohydrate and lipid metabolism, serum levels of LP-PLA2 and TNF-a. Two groups of patients were formed: the 1st group — patients with HFmrEF and DM who had myocardial infarction (MI), 37 people (47.4%), the 2nd group — patients with HFmrEFand DM, 41 people (52.6%). Results. An increase in the content of LP-PLA2 and TNF-a with an increase in CHF FC was revealed. In the 1st group, the levels of inflammation biomarkers, insulin, HOMA-IR, total cholesterol, low density lipoproteins significantly exceeded those in the 2nd group. A positive correlation was found between the levels of LP-PLA2 and TNF-a and the parameters of carbohydrate and lipid metabolism. Conclusion. The progression of DM and HFmrEF is accompanied by an increase in chronic inflammation and an increase in the content of Lp-PLA2 and TNF-a with an increase in CHF FC. The association of elevated levels of inflammatory biomarkers with carbohydrate and lipid metabolism is an additional factor of HFmrEF progression in patients with DM. An increase in the serum levels of inflammatory biomarkers in patients with HFmrEF and DM who underwent MI, compared with patients with HFmrEF and DM, makes it possible to use LP-PLA2 and TNF-a for diagnosing complications in patients with DM and HFmrEF.","PeriodicalId":9821,"journal":{"name":"中国实用医药","volume":"2012 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82624259","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}
Pub Date : 2023-01-01DOI: 10.32000/2072-1757-2023-4-63-71
E. S. Kosarenko, T. V. Zuevskaya, M. D. Orlov, S. I. Eremeev, S. S. Romanchenko
The purpose — to determine the laboratory features of autoimmune liver diseases occurring against the background of opisthorchiasis invasion, to assess the effect of opisthorchiasis on the course of autoimmune liver diseases. Material and methods The study is a prospective analysis of the survey results of patients with autoimmune liver diseases and combined autoimmune and parasitic liver damage. The methodological basis of the study was general scientific, general logical and special methods. Results. A comparative analysis of laboratory parameters in autoimmune liver diseases with and without opisthorchiasis invasion was carried out. It was found that patients with comorbidity had statistically significantly higher levels of urea (p=0.001), glucose (p=0.014) and total cholesterol (p = 0.012). Conclusion. It was determined that in autoimmune liver diseases associated with opisthorchiasis, there are no specific pathognomonic laboratory signs, which is important to consider when conducting differential diagnosis. Therefore, all patients suffering from opisthorchiasis, regardless of the previously established diagnosis, in the presence of hepatosplenomegaly, persistent cytolysis and/or cholestasis, require an additional examination for autoimmune liver damage, according to the current diagnostic algorithms, especially if they are combined with anemia and other cytopenias, autoimmune diseases, aggravated heredity for autoimmune pathology, or a sharp increase in γ-globulins (IgG).
{"title":"Laboratory features of autoimmune liver diseases against the background of opisthorchiasis invasion","authors":"E. S. Kosarenko, T. V. Zuevskaya, M. D. Orlov, S. I. Eremeev, S. S. Romanchenko","doi":"10.32000/2072-1757-2023-4-63-71","DOIUrl":"https://doi.org/10.32000/2072-1757-2023-4-63-71","url":null,"abstract":"The purpose — to determine the laboratory features of autoimmune liver diseases occurring against the background of opisthorchiasis invasion, to assess the effect of opisthorchiasis on the course of autoimmune liver diseases. Material and methods The study is a prospective analysis of the survey results of patients with autoimmune liver diseases and combined autoimmune and parasitic liver damage. The methodological basis of the study was general scientific, general logical and special methods. Results. A comparative analysis of laboratory parameters in autoimmune liver diseases with and without opisthorchiasis invasion was carried out. It was found that patients with comorbidity had statistically significantly higher levels of urea (p=0.001), glucose (p=0.014) and total cholesterol (p = 0.012). Conclusion. It was determined that in autoimmune liver diseases associated with opisthorchiasis, there are no specific pathognomonic laboratory signs, which is important to consider when conducting differential diagnosis. Therefore, all patients suffering from opisthorchiasis, regardless of the previously established diagnosis, in the presence of hepatosplenomegaly, persistent cytolysis and/or cholestasis, require an additional examination for autoimmune liver damage, according to the current diagnostic algorithms, especially if they are combined with anemia and other cytopenias, autoimmune diseases, aggravated heredity for autoimmune pathology, or a sharp increase in γ-globulins (IgG).","PeriodicalId":9821,"journal":{"name":"中国实用医药","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81032250","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}
Pub Date : 2023-01-01DOI: 10.32000/2072-1757-2023-3-32-39
F. Rizatdinova, D. Abdulganieva
Psoriatic arthritis (PsA) is a chronic autoimmune disease that increases the risk of cardiovascular diseases (CVD) such as myocardial infarction, stroke, arrhythmias, and conduction disorders. Traditional risk factors such as hypertension, dyslipidaemia, and obesity may only partly explain the increased risk. Many factors, including chronic inflammation, metabolic syndrome, autonomic dysfunction, and endothelial dysfunction, may play a role in increasing the risk of CVD. PsA is associated with direct myocardial damage, left ventricular remodeling, electrocardiographic abnormalities, and arrhythmias, including fatal ones. This review considers the main CVDs, risk factors, the mechanisms of influence of PsA and its activity and phenotypes on these risk factors, as well as the possible interventions to reduce the risk of CVD in patients with PsA.
{"title":"Psoriatic arthritis and cardiovascular diseases","authors":"F. Rizatdinova, D. Abdulganieva","doi":"10.32000/2072-1757-2023-3-32-39","DOIUrl":"https://doi.org/10.32000/2072-1757-2023-3-32-39","url":null,"abstract":"Psoriatic arthritis (PsA) is a chronic autoimmune disease that increases the risk of cardiovascular diseases (CVD) such as myocardial infarction, stroke, arrhythmias, and conduction disorders. Traditional risk factors such as hypertension, dyslipidaemia, and obesity may only partly explain the increased risk. Many factors, including chronic inflammation, metabolic syndrome, autonomic dysfunction, and endothelial dysfunction, may play a role in increasing the risk of CVD. PsA is associated with direct myocardial damage, left ventricular remodeling, electrocardiographic abnormalities, and arrhythmias, including fatal ones. This review considers the main CVDs, risk factors, the mechanisms of influence of PsA and its activity and phenotypes on these risk factors, as well as the possible interventions to reduce the risk of CVD in patients with PsA.","PeriodicalId":9821,"journal":{"name":"中国实用医药","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73801235","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}
Pub Date : 2023-01-01DOI: 10.32000/2072-1757-2023-4-113-115
Z. Mazhidova, I. I. Musin, A. G. Yashchuk, E. A. Berg, A. G. Imelbaeva
The purpose to study the role of polymorphisms of endothelial nitric oxide synthase (eNOS3 G894T), transforming growth factor beta TGF-β (CA rs1800470) and plasminogen activator inhibitor (SERPINE-1 5G (-675)4G) in full-term pregnant women in the development of purulent-septic complications after cesarean section in the lower uterine segment. Material and methods. The authors analyzed obstetric complications after cesarean section in the lower uterine segment. Prospectively, 81 maternity patients after single-fetus delivery by caesarean section in the lower uterine segment were monitored and treated for emergency indications in order to diagnose purulent-septic complications and perform genetic analysis. The Statistica 10.0 and Eviews 12.0 software packages were used for statistical processing of the obtained results. Results. A direct correlation was established between the presence of a homozygous mutation of the transforming growth factor-β1 gene (TGF-β (CA rs1800470)), as well as the presence of a homozygous mutation of the endothelial nitric oxide synthase eNOS3 (G894T) gene, with significant risk factors for purulent-septic complications after cesarean section in full-term pregnancy: obesity 3-grade II (rs = 0.467, p < 0.001; rs = 0.461, p = 0.005) and pathological overall weight gain during pregnancy (rs = 0.660, p < 0.001; rs = 0.385, p = 0.024). Conclusion. The genetic study data allow concluding that homozygous polymorphisms of the studied genes of transforming growth factor-β1 (TGF-β (CA rs1800470)) and endothelial nitric oxide synthase eNOS3 (G894T) are associated both with the presence of purulent-septic diseases in the postpartum period after cesarean section in the lower uterine segment, and with metabolic disorders such as obesity of the 3rd degree and pathological overall weight gain during pregnancy. It is the combination of these factors that significantly increases the risks of obstetric purulent-septic complications in women with this genotype.
目的探讨足月孕妇内皮型一氧化氮合酶(eNOS3 G894T)、转化生长因子β - TGF-β (CA rs1800470)及纤溶酶原激活物抑制剂(SERPINE-1 5G (-675)4G)多态性在剖宫产术后下子宫段脓毒性并发症发生中的作用。材料和方法。作者分析了下子宫段剖宫产术后的产科并发症。前瞻性地对81例下子宫段剖宫产单胎产妇进行监测和急诊指征治疗，以诊断脓毒性并发症并进行遗传分析。使用Statistica 10.0和Eviews 12.0软件包对所得结果进行统计处理。结果。转化生长因子-β1基因(TGF-β (CA rs1800470))纯合突变的存在与内皮型一氧化氮合酶eNOS3 (G894T)基因纯合突变的存在与足月妊娠剖宫产术后脓毒性并发症的显著危险因素有直接相关性:肥胖3级(rs = 0.467, p < 0.001;Rs = 0.461, p = 0.005)和病理性总体重增加(Rs = 0.660, p < 0.001;Rs = 0.385, p = 0.024)。结论。遗传研究数据表明，所研究的转化生长因子-β1 (TGF-β (CA rs1800470))和内皮型一氧化氮合酶eNOS3 (G894T)基因的纯合多态性与剖宫产后下子宫段产后出现脓毒性疾病有关，也与妊娠期3度肥胖、病理性总体重增加等代谢紊乱有关。正是这些因素的结合显著增加了该基因型妇女发生产科脓毒症并发症的风险。
{"title":"Role of genetic factors in the development of purulent-septic complications in obstetrics","authors":"Z. Mazhidova, I. I. Musin, A. G. Yashchuk, E. A. Berg, A. G. Imelbaeva","doi":"10.32000/2072-1757-2023-4-113-115","DOIUrl":"https://doi.org/10.32000/2072-1757-2023-4-113-115","url":null,"abstract":"The purpose to study the role of polymorphisms of endothelial nitric oxide synthase (eNOS3 G894T), transforming growth factor beta TGF-β (CA rs1800470) and plasminogen activator inhibitor (SERPINE-1 5G (-675)4G) in full-term pregnant women in the development of purulent-septic complications after cesarean section in the lower uterine segment. Material and methods. The authors analyzed obstetric complications after cesarean section in the lower uterine segment. Prospectively, 81 maternity patients after single-fetus delivery by caesarean section in the lower uterine segment were monitored and treated for emergency indications in order to diagnose purulent-septic complications and perform genetic analysis. The Statistica 10.0 and Eviews 12.0 software packages were used for statistical processing of the obtained results. Results. A direct correlation was established between the presence of a homozygous mutation of the transforming growth factor-β1 gene (TGF-β (CA rs1800470)), as well as the presence of a homozygous mutation of the endothelial nitric oxide synthase eNOS3 (G894T) gene, with significant risk factors for purulent-septic complications after cesarean section in full-term pregnancy: obesity 3-grade II (rs = 0.467, p < 0.001; rs = 0.461, p = 0.005) and pathological overall weight gain during pregnancy (rs = 0.660, p < 0.001; rs = 0.385, p = 0.024). Conclusion. The genetic study data allow concluding that homozygous polymorphisms of the studied genes of transforming growth factor-β1 (TGF-β (CA rs1800470)) and endothelial nitric oxide synthase eNOS3 (G894T) are associated both with the presence of purulent-septic diseases in the postpartum period after cesarean section in the lower uterine segment, and with metabolic disorders such as obesity of the 3rd degree and pathological overall weight gain during pregnancy. It is the combination of these factors that significantly increases the risks of obstetric purulent-septic complications in women with this genotype.","PeriodicalId":9821,"journal":{"name":"中国实用医药","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73887018","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}
Pub Date : 2023-01-01DOI: 10.32000/2072-1757-2023-4-72-75
E. V. Mokretsova, G. S. Tomilka, YU. G. Kovalskiy, A. Y. Shchupak, V. V. Maleev
The purpose — to study the dynamics of serum selenium and cadmium levels in patients with a moderate form of tick-borne rickettsiosis caused by R. heilongjiangensis, depending on the disease stage, with a view of identifying the relationship between the studied trace elements. Material and methods. The levels of cadmium and selenium were studied and analyzed in patients with a moderate form of tick-borne rickettsiosis caused by R. heilongjiangensis, without concomitant chronic diseases in the decompensation stage. Results. It was found that the average level of cadmium in the blood serum of patients at the height of the disease was statistically significantly increased by 1.5 times, which was combined with a significant decrease of 1.3 times in the level of selenium to critical values. During the convalescence period, the cadmium level significantly decreased, having no significant differences with the comparison group, while the selenium level increased reliably by the time of discharge relative to the height of the disease. Correlation analysis revealed a reliable negative relationship of intermediate strength between the selenium and cadmium content in blood serum. Conclusion. The data obtained, indicating the formation of critical cadmium redundancy against the background of selenium deficiency in patients with a moderate form at the height of tick-borne rickettsiosis caused by R. heilongjiangensis, testify to the conjugation of the processes of selenium and cadmium statuses. The imbalance of the studied trace elements is probably reflected in a decrease in the activity of antioxidant antiradical protection.
{"title":"Investigation of the dynamics of the level of certain trace elements in patients with tick-borne rickettsiosis in Khabarovsk krai","authors":"E. V. Mokretsova, G. S. Tomilka, YU. G. Kovalskiy, A. Y. Shchupak, V. V. Maleev","doi":"10.32000/2072-1757-2023-4-72-75","DOIUrl":"https://doi.org/10.32000/2072-1757-2023-4-72-75","url":null,"abstract":"The purpose — to study the dynamics of serum selenium and cadmium levels in patients with a moderate form of tick-borne rickettsiosis caused by R. heilongjiangensis, depending on the disease stage, with a view of identifying the relationship between the studied trace elements. Material and methods. The levels of cadmium and selenium were studied and analyzed in patients with a moderate form of tick-borne rickettsiosis caused by R. heilongjiangensis, without concomitant chronic diseases in the decompensation stage. Results. It was found that the average level of cadmium in the blood serum of patients at the height of the disease was statistically significantly increased by 1.5 times, which was combined with a significant decrease of 1.3 times in the level of selenium to critical values. During the convalescence period, the cadmium level significantly decreased, having no significant differences with the comparison group, while the selenium level increased reliably by the time of discharge relative to the height of the disease. Correlation analysis revealed a reliable negative relationship of intermediate strength between the selenium and cadmium content in blood serum. Conclusion. The data obtained, indicating the formation of critical cadmium redundancy against the background of selenium deficiency in patients with a moderate form at the height of tick-borne rickettsiosis caused by R. heilongjiangensis, testify to the conjugation of the processes of selenium and cadmium statuses. The imbalance of the studied trace elements is probably reflected in a decrease in the activity of antioxidant antiradical protection.","PeriodicalId":9821,"journal":{"name":"中国实用医药","volume":"75 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75889760","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}
Pub Date : 2023-01-01DOI: 10.32000/2072-1757-2023-3-45-50
R. I. Sadykov, I. Akhtyamov, S. Lapshina, K. T. Shoshorina
Gonarthrosis is a chronic degenerative-inflammatory disease of the knee joint in which all components of the joint are affected. In current clinical guidelines for the treatment of osteoarthritis of the knee, the first step in therapy is the prescription of symptom-modifying drugs with delayed action. One of the most well-studied and effective of these drugs is chondroitin sulfate. A promising remedy for the treatment of gonarthrosis is intra-articular injections, primarily of high-molecular-weight hyaluronic acid preparations, which have proven effective in clinical practice. Their use at an early stage of the disease can contribute to a more complete implementation of the potential of these drugs. The purpose — to study the effect of the combined use of chondroitin sulfate and the Revisk synovial fluid prosthesis on reducing the severity of pain and improving functionality in patients with knee osteoarthritis. Material and methods. 60 patients with stage I–II gonarthrosis according to Kellgren-Lawrence, with intensity of pain according to VAS ≥ 50 mm, and with algofunctional Lequesne index ≥ 5 points were divided into three comparable groups of 20 people. All patients had no contraindications for intramuscular injection of chondroitin sulfate and intraarticular injection of hyaluronic acids, there were no anamnestic indications of their intolerance. In the comparison groups, patients received monotherapy with chondroitin sulfate intramuscularly (group 1) and hyaluronic acid 2.2% (group 2), in the main group, patients received combined therapy with chondroitin sulfate intramuscularly and Revisk intraarticular hyaluronic acid. The effectiveness of therapy was assessed by the dynamics of pain according to the VAS, the algofunctional index of Lequesne, the WOMAC index, and the EQ-5D questionnaire. Results. With the combined use of chondroitin sulfate and the Revisk synovial fluid prosthesis, a clinically more significant decrease in pain syndrome and an improvement in functional parameters were revealed than with monotherapy with chondroitin sulfate, and than with a single administration of hyaluronic acid preparations. At the end of the course of therapy, the severity of the pain syndrome decreased by 75.57%. Conclusions. The data obtained allow the use of both drugs in the complex therapy of knee osteoarthritis in patients with comorbidity. The combined use of chondroitin sulfate and Revisk synovial fluid prosthesis in patients with osteoarthritis of the knee joints reduces the severity of pain, improves functional activity, improves the quality of life of patients.
{"title":"Evaluation of the effectiveness and safety of combined therapy with chondroitin sulfate and Revisk synovial fluid endoprosthesis in patients with osteoarthritis of the knee joints","authors":"R. I. Sadykov, I. Akhtyamov, S. Lapshina, K. T. Shoshorina","doi":"10.32000/2072-1757-2023-3-45-50","DOIUrl":"https://doi.org/10.32000/2072-1757-2023-3-45-50","url":null,"abstract":"Gonarthrosis is a chronic degenerative-inflammatory disease of the knee joint in which all components of the joint are affected. In current clinical guidelines for the treatment of osteoarthritis of the knee, the first step in therapy is the prescription of symptom-modifying drugs with delayed action. One of the most well-studied and effective of these drugs is chondroitin sulfate. A promising remedy for the treatment of gonarthrosis is intra-articular injections, primarily of high-molecular-weight hyaluronic acid preparations, which have proven effective in clinical practice. Their use at an early stage of the disease can contribute to a more complete implementation of the potential of these drugs. The purpose — to study the effect of the combined use of chondroitin sulfate and the Revisk synovial fluid prosthesis on reducing the severity of pain and improving functionality in patients with knee osteoarthritis. Material and methods. 60 patients with stage I–II gonarthrosis according to Kellgren-Lawrence, with intensity of pain according to VAS ≥ 50 mm, and with algofunctional Lequesne index ≥ 5 points were divided into three comparable groups of 20 people. All patients had no contraindications for intramuscular injection of chondroitin sulfate and intraarticular injection of hyaluronic acids, there were no anamnestic indications of their intolerance. In the comparison groups, patients received monotherapy with chondroitin sulfate intramuscularly (group 1) and hyaluronic acid 2.2% (group 2), in the main group, patients received combined therapy with chondroitin sulfate intramuscularly and Revisk intraarticular hyaluronic acid. The effectiveness of therapy was assessed by the dynamics of pain according to the VAS, the algofunctional index of Lequesne, the WOMAC index, and the EQ-5D questionnaire. Results. With the combined use of chondroitin sulfate and the Revisk synovial fluid prosthesis, a clinically more significant decrease in pain syndrome and an improvement in functional parameters were revealed than with monotherapy with chondroitin sulfate, and than with a single administration of hyaluronic acid preparations. At the end of the course of therapy, the severity of the pain syndrome decreased by 75.57%. Conclusions. The data obtained allow the use of both drugs in the complex therapy of knee osteoarthritis in patients with comorbidity. The combined use of chondroitin sulfate and Revisk synovial fluid prosthesis in patients with osteoarthritis of the knee joints reduces the severity of pain, improves functional activity, improves the quality of life of patients.","PeriodicalId":9821,"journal":{"name":"中国实用医药","volume":"61 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83766807","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}
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