Vol 69, No 7-8 (2014)

PHYSIOLOGY: CURRENT ISSUES
RESUSCITATION OF VITAL ACTIVITY AFTER COLD ARREST OF RESPIRATION BY PHYSIOLOGICAL METHODS WITHOUT REWARMING THE BODY
Ivanov K.P.
Abstract

The arrest of respiration during deep hypothermia means death, though at a low temperature the heart may rhythmically contract for 30–40 minutes more. The attempts of rewarming only shorten the time before the heart arrest. “The aim of the study” the attempts to develop the methods of stimulating the respiration and heart without rewarming the body. Calcium ions (Ca2+) are believed to accumulate in the nervous cells in cold. An excess of these ions inhibits the metabolism. Moreover it stimulates the cell proteases, which destroy the cell membranes. “Materials and methods” The work was carried out on wite rats 250-320 g in weight. We introduced disodium salt of ethylenediaminetetraacetic acid (EDTA) into the animals. The second method of blocking the mechanisms of the cold death was artificial respiration. “Results”EDTA  reacts with calcium ions, decreases their quantity in the blood, and, consequently, in a complex manner in the cell protoplasm. Artificial respiration not only increases the flow of oxygen into an organism but also decreases the lowest temperature threshold of the cold death of an organism. “Conclusions” A decrease in the surviving threshold by 1.5-1.8oC is very important from the point of view of reanimation of an organism since to preserve life in the critical period of reanimation each 0.5oC are important. Prolongation of minimal frequency of heart contractions and maintaining a minimal arterial blood pressure in an overcooled organism given the body temperature of 11-12.5oC is a special problem of great interest associated with many physiological and biological parameters.

 
Annals of the Russian academy of medical sciences. 2014;69(7-8):5-9
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NEUROSIS AND GENETIC THEORY OF ETIOLOGY AND PATHOGENESIS OF ULCER DISEASE
Kolotilova M.L., Ivanov L.N.
Abstract
Based on the analysis of literature data and our own research, we have developed the original concept of etiology and pathogenesis of peptic ulcer disease. An analysis of the literature shows that none of the theories of pathogenesis of peptic ulcer disease does not cover the full diversity of the involved functions and their shifts, which lead to the development of ulcers in the stomach and the duodenum. Our neurogenic-genetic theory of etiology and pathogenesis of gastric ulcer and duodenal ulcer very best explains the cause-and-effect relationships in the patient peptic ulcer, allowing options for predominance in one or the other case factors of neurosis or genetic factors. However, it is clear that the only other: combination of neurogenic factor with genetically modified reactivity of gastroduodenal system (the presence of the target organ) cause the chronicity of the sores. The theory of peptic ulcer disease related to psychosomatic pathologies allows us to develop effective schema therapy, including drugs with psychocorrective action. On the basis of our theory of the role of Helicobacter pylori infection is treated as a pathogenetic factor in the development of peptic ulcer disease.

Annals of the Russian academy of medical sciences. 2014;69(7-8):10-16
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INTERSTITIAL PACEMAKER CELLS
Nizyaeva N.V., Marei M.V., Sukhikh G.T., Shchegolev A.I.
Abstract
This article is devoted to interstitial Cajal cells (syn. telocytes, interstitial pacemaker cells, IPC). First those cells were discovered by C.R Cajal in the muscle coat of the gut in 1893. Nowadays they have revealed in all parts of digestive systems (from esophagus to rectum), urinary and biliary tracts, prostate, liver, the walls of arteries and lymphatics, as well Fallopian tube, myometrium, mammary glands. Characteristic ultrastructural features are elongated spindle shape, length from 40 to 100 μm, the thickness of 0.2–0.5 μm, the presence of 2–5 processes. Length of them ranging from tens to hundreds of micrometers, some of them have secondary and tertiary branching, forming a three-dimensional network. IPC having spontaneous electrical (pacemaker) activity are cause to contraction of smooth muscle cells. Depending on the location of IPC have different morphological and ultrastructural characteristics. Characteristic immunohistochemical markers are CD117, CD34, S100, vimentin. IPC replay to acetylcholine, norepinephrine, estrogen, progesterone, and nitric oxide by influence of corresponding receptors. IPC have specific gap junctions with lymphocytes, basophiles, eosinophils, neutrophils, mast cells and dendritic cells. Grave pathology of those cells are forming gastrointestinal stromal tumors.

Annals of the Russian academy of medical sciences. 2014;69(7-8):17-24
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THE IMPACT OF IMMUNOACTIVE DRUGS ON PASSIVE AVOIDANCE RESPONSE
Novoseletskaya A.V., Kiseleva N.M., Belova O.V., Zimina I.V., Moskvina S.N., Bystrova O.V., Inozemtsev A.N., Arion V.Y., Sergienko V.I.
Abstract
Aim: The objective of this project was to explore the influence of immunoactive drugs (tactivin, thymulin, and thymosin fraction 5) on the development of the passive avoidance conditioned reflex. Materials and methods: Two types of passive avoidance boxes were used — a regular two-chamber box and a modified three-chamber box, comprising a dark chamber in which rats were exposed to electrical shock, a safe dark chamber, and a light chamber in the center. Results: The project has established that the memory trace persists longer under the influence of the immunoactive drugs in both models, which is consistent with the reference nootropic piracetam test results. Notably, the immunoactive drugs' mnemotropic effect was more pronounced in the modified three-chamber box than in the standard two-chamber box. Using the modified box helped to establish the influence of tactivin, thymulin, and thymosin fraction 5 on the spatial memory component. Immunotropic preparations from thymus caused the animals to select the safe chamber 24 hours later and in subsequent tests. Conclusion: The project’s results indicate that the drugs tested do possess mnemotropic properties, so their range of clinical use can be broadened.

Annals of the Russian academy of medical sciences. 2014;69(7-8):25-29
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IMMUNE DYSFUNCTION AND COGNITIVE DEFICIT IN STRESS AND PHYSIOLOGICAL AGING. PART II: NEW APPROACHES TO COGNITIVE DISORDER PREVENTION AND TREATMENT
Pikhal'skii A.L., Shmarina G.V., Aleshkin V.A.
Abstract
Long-term stress as well as physiological aging result in similar immunological and hormonal disturbances including hypothalamic-pituitaryadrenal) axis depletion, aberrant immune response (regulatory T-cells, Tregs, and Th17-lymphocyte accumulation) and decreased dehydroepiandrosterone synthesis both in the brain and in the adrenal glands. Since the main mechanisms of inflammation control, «prompt» (stress hormones) and «delayed» (Tregs), are broken, serum cytokine levels increase and become sufficient for blood-brain-barrier disruption. As a result peripheral cytokines penetrate into the brain where they begin to perform new functions. Structural and functional alterations of blood-brain-barrier as well as stress- (or age-) induced neuroinflammation promote influx of bone marrow derived dendritic cells and lymphocyte effectors into the brain parenchyma. Thereafter, mass intrusion of pro-inflammatory mediators and immune cells having a lot of specific targets alters the brain work that we can observe both in humans and in animal experiments. The concept of stressful cognitive dysfunction, which is under consideration in this review, allows picking out several therapeutic targets: 1) reduction of excessive Treg accumulation; 2) supporting hypothalamic-pituitary-adrenal axis and inflammatory reaction attenuation; 3) recovery of dehydroepiandrosterone level; 4) improvement of blood-brain-barrier function.

Annals of the Russian academy of medical sciences. 2014;69(7-8):30-37
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MICROBIOLOGY: CURRENT ISSUES
SEROTYPE DIVERSITY AND ANTIMICROBIAL RESISTANCE OF STREPTOCOCCUS PNEUMONIAE
Mayanskii N.A., Alyab'eva N.M., Lazareva A.V., Katosova L.K.
Abstract
The pneumococcus (Streptococcus pneumoniae) is a common bacterial pathogen responsible for various infections, especially in children below
5 years of age. The severity of pneumococcal infections varies from self-limiting mucosal infections, including acute otitis media, sinusitis, and noninvasive pneumonia, to life-threatening invasive disease like bacteremia and meningitis. A high incidence of pneumococcal infections is combined with a constantly growing antibiotic resistance of this pathogen. The growing resistance is thought to be associated with misuse of antibiotics and emerging of resistant clones that may spread throughout the entire population. Pneumococcal polysaccharide conjugate vaccines (PCV) contain an assortment of pneumococcal capsular polysaccharides (from 7 to 13) that produce serotype-specific protective antibodies. Since early 2000’s, the introduction of PCV into national immunization programs has been shown to substantially decrease the incidence of invasive pneumococcal disease and pneumococcal carriage associated with vaccine-type pneumococci in many countries. In 2014, PCV vaccination was included in the Russian national calendar of prophylactic vaccination. The present article reviews the current literature on serotype prevalence, antibiotic susceptibility, and PCV effect on the evolution of pneumococcus.

Annals of the Russian academy of medical sciences. 2014;69(7-8):38-45
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MICROEVOLUTION OF CHOLERA AGENT IN THE MODERN PERIOD
Smirnova N.I., Agafonov D.A., Kul'shan' T.A., Krasnov Y.M., Kutyrev V.V.
Abstract
Aim: To carry out comparative molecular genetic analysis of highly pathogenic atypical Vibrio cholerae strains biovar El Tor, isolated in the territory of RF, in order to determine micro-evolutionary alterations of cholera agent in the modern period. Materials and methods: 38 clinical strains have been examined by means of polymerase chain reaction, sequencing and MLVA-analysis. The selected strains were isolated at different periods of time during cholera epidemic complications and differed between each other in virulence. Results: It is demonstrated that new variants have emerged in the course of short-term microevolution. Their genome structure and function differ from those of all previously known strains. The genome alterations have been caused by point mutations in ctxB и tcpA genes associated with virulence and located in CTXφ prophage and pathogenicity island VPI-1 respectively, as well as by the extended deletion in pandemicity island VSP-II. Presented is the dynamics of genome structure and function alterations in modern strains. Conclusion: The discovered genomic alterations in the new variants of the agent evolved in the process of microevolution are indicative of their epidemic potential enhancement and probability of virulence potentiation.

Annals of the Russian academy of medical sciences. 2014;69(7-8):46-53
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PEDIATRICS: CURRENT ISSUES
ENDOGENOUS INTOXICATION AND BIOCHEMICAL PROTECTION IN CHILDREN WITH CELIAC DISEASE: STATE ASSESMENT AND CORRELATION-REGRESSION ANALYSIS
Uspenskaya I.D., Shabunina E.I., Zhukova E.A., Erzutova M.V., Korkotashvili L.V.
Abstract
Aim: The purpose of the study was to determine the characteristics of endogenous intoxication parameters, biochemical protection and reveal their
interaction in children with celiac disease. Materials and methods: 81 children aged from 1 to 16 years with celiac disease were examined in acute and remission periods. In erythrocytes, blood serum and urine we determined low and moderate molecular weight substances (LMMWS), oligopeptides (OP); in erythrocytes — the value of erythrocyte mechanical hemolysis (MH), malondialdehyde (MDA) content, the activity of glutathione reductase (GR) and superoxide dismutase (SOD); in blood serum — ceruloplasmin (CP) level, alcohol dehydrogenase (ADH) activity; in erythrocytes and blood serum — glutathione transferase (GT), and calculated intoxication index (II). Results: In children with celiac disease in acute and remission periods LMMWS, OP, II levels in blood were statistically significantly high, while LMMWS level in urine was low. In both periods MH activity was high (p <0.001), and GSR (p <0.001) and SOD (p <0.01) levels were low. We revealed the correlation between MDA and II (r =0.67; p =0.006), erythrocyte LMMWS and SOD (r = -0.61; p =0.015), erythrocyte LMMWS and ADH (r =0.62; p =0.006), between GT and OP in urine (r = -0.31; p =0.026), GT and MDA (r =0.68; p =0.000), GT and MH (r = -0.46; p =0.004), between MDA and CP (r =0.57; p =0.002) that made it possible to develop the models of dependence of the parameters in relation to each other. Conclusion: In celiac disease there is endogenous intoxication. The changes of the first and the second phases of biotransformation, antioxidant protection is an essential factor of the disease pathogenesis, since they have an effect on endogenous intoxication formation that should be taken into consideration in therapy.

Annals of the Russian academy of medical sciences. 2014;69(7-8):93-99
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FEATURES OF PATIENTS WITH THE MULTIPLE SENSITIZATION DIAGNOSTICS BEFORE ALLERGEN SPECIFIC IMMUNOTHERAPY WILL BE SET AND THE ASSESSMENT OF THE THERAPY RESULTS WITH THE LABORATORY METHODS
Snovskaya M.A., Namazova-Baranova L.S., Semikina E.L., Kozhevnikova O.V.
Abstract
Background: Due to the wide expansion of atopy, its early beginning, variety of forms, difficulty of specific pathogenetic treatment, and also high
cost of in vitro researches there is a need of diagnostic test systems development and optimization. Aim: To make the assessment of atopy diagnostics efficiency in children with a multiple allergy and the analysis of specific immunotherapy (ASIT) influence on immune markers level in serum for a choice of the most significant predictive indicator. Patients and methods: 457 children (mean age 8,9±4,3 years) with pollinosis symptoms that prevalence in spring period were tested with birch pollen allergens extract by detecting allergen-specific immunoglobulin E (sIgE) levels. Than patient witch showed positive sIgE level (243 children) were tested with expanded set of plant allergens (birch, alder, hazel, oak pollen, allergens of Rosaceae family and carrot) and set of birch pollen allergocomponents (Bet v1, Bet v2, Bet v4, Bet v6). From them 32 patients were treated with allergenspecific immunotherapy. Immunological assays were performed by indirect immunofluorescent method on ImmunoCAP250 (Sweden). Results: It was shown that birch allergens sIgE antibodies detection in patients with pollinosis allows to estimate sensitization degree to allergens of related trees and could predict their quantitative values. The oak allergens sIgE level is a good predictive marker of sIgE level to food plant derived allergens. And apple allergens sIgE concentration is closely assotiated with sIgE to fruit allergens of Rosacea family. Detection of sensitization to minor allergens in patient influences on therapy efficacy prognosis. Conclusion: sIgE detection to limited number of allergens (birch-oak-apple) is effective to sIgE value assessment in patient with allergy to plant causing allergens cross reactivity. Component-divided in vitro diagnostics directed on reveal of sensitization caused by minor allergens, is actual at the answer a question about ASIT validity and its efficiency. Component-divided in vitro diagnostics directed on reveal of sensitization caused by minor allergens, is actual at the answer a question about ASIT validity and its efficiency. Significant results of the therapy are shown after double course ASIT that also allows to reduce considerably production of sIgE antibodies to significant allergens, and cross reacting plant food allergens.

Annals of the Russian academy of medical sciences. 2014;69(7-8):85-92
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OPEN, NON-COMPARATIVE PHASE III CLINICAL STUDY TO EVALUATE THE EFFICACY AND SAFETY OF SAPROPTERIN IN PATIENTS WITH PHENYLKETONURIA AND HYPERPHENYLALANINEMIA
Bushueva T.V., Kuzenkova L.M., Borovik T.E., Nazarenko L.P., Seitova G.N., Filimonova M.N., Pichkur N.A., Samonenko N.V., Shkurko T.A., Akhmadeeva E.N., Mardanova A.K., Garifullina E.R., Kovtun O.P., Bazhenova Y.L., Alimova I.L., Kostyakova E.A., Minaicheva L.I., Salyukova O.A., Sivokha V.M., Rosenson O.L.
Abstract
Background: Phenylketonuria (PKU) is an autosomal recessive inherited disease associated with impaired metabolism of the amino acids
phenylalanine (Phe) and tyrosine. The main criterion for diagnosis of PKU is high blood Phe level determined during neonatal screening. In case where PKU patient is responsive to tetrahydrobiopterin treatment, sapropterin restores the impaired activity of the enzyme phenylalanine hydroxylase, resulting in the stimulation of normal Phe metabolism and thereby enhancing patient tolerance to natural products. Aim: The present open, noncomparative clinical study was initiated to assess the degree and frequency of response after 8-day sapropterin administration and assess the safety of 6-week sapropterin treatment in patients with PKU and hyperphenylalaninemia. Patients and methods: The study enrolled 90 patients with PKU. The criterion of response to 8-day sapropterin therapy was the reduction of Phe blood levels 30% compared with the baseline value. Results: Positive response to treatment was observed in 30 (33.3%) patients (95% CI 23.7–44.1). The mean percentage change in Phe blood levels after the 8-day response test period compared to Phe levels prior to dosing was 14.1±28.4% in the overall subject population (95% CI 8.2–20.1) and 44.3±15.1% in the subpopulation of patients with a positive response (95% CI 38.6–49.9). During the study, adverse events were reported in 24 (26.7%) patients in the overall population in 16 (53.3%) patients in the subpopulation who had a response. Conclusion: The study results confirmed the efficacy and safety of sapropterin therapy in patients with PKU, which is consistent with international clinical trials data.

Annals of the Russian academy of medical sciences. 2014;69(7-8):69-77
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PALIVIZUMAB: FOUR SEASONS IN RUSSIA
Baranov A.A., Ivanov D.O., Alyamovskaya G.A., Amirova V.R., Antonyuk I.V., Asmolova G.A., Belyaeva I.A., Bokeriya E.L., Bryukhanova O.A., Vinogradova I.V., Vlasova E.V., Galustyan A.N., Gafarova G.V., Gorev V.V., Davydova I.V., Degtyarev D.N., Degtyareva E.A., Dolgikh V.V., Donin I.M., Zakharova N.I., Zernova L.Y., Zimina E.P., Zuev V.V., Keshishyan E.S., Kovalev I.A., Koltunov I.E., Korsunskii A.A., Krivoshchekov E.V., Krsheminskaya I.V., Kuznetsova S.N., Lyubimenko V.A., Namazova-Baranova L.S., Nesterenko E.V., Nikolaev S.V., Ovsyannikov D.Y., Pavlova T.I., Potapova M.V., Rychkova L.V., Safarov A.A., Safina A.I., Skachkova M.A., Soldatova I.G., Turti T.V., Filatova N.A., Shakirova R.M., Yanulevich O.S.
Abstract
In 2010, the Russian Federation (RF) registered palivizumab — innovative drug, based on monoclonal antibodies for passive immunization of seasonal respiratory syncytial virus (RSV) infection in children of disease severe progress risk group, which include primarily premature infants, children with bronchopulmonary dysplasia and hemodynamically significant congenital heart disease. Currently, palivizumab is included in the list of recommended medicines and medical care standards of different countries, including Russia. In the review the results of Russian research on the progress of RSV infection, its epidemiology and immunization experience gained over the 2010–2014 period are summarized in relation to the foreign data. During the four epidemic seasons palivizumab immunization covered more than 3,200 children of severe RSV infection risk group with a progressive annual increase in the number of patients who received the drug. Geography of palivizumab immunization is also greatly expanded in our country during this time. If during the first two seasons measures of immunization were taken mainly in Moscow and St. Petersburg, at the present time, thirty one territorial entities of the Russian Federation have the experience in the drug application. Analysis of the results of RSV infection immunization (made in several regions) confirms the high clinical efficacy and palivizumab safety already demonstrated in international studies. In addition, the analysis presents the potential to improve the efficiency of the integrated RSV infection immunization programs, realizing in the establishment of high-risk child group register, adequate counseling for parents, as well as the development of the routing of patients and coordination of interaction between different health institutions during the immunization.

Annals of the Russian academy of medical sciences. 2014;69(7-8):54-68
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MITOCHONDRIAL DYSFUNCTION IN CHILDREN WITH HEPATIC FORMS OF GLYCOGEN STORAGE DISEASE
Kurbatova O.V., Surkov A.N., Namazova-Baranova L.S., Polyakova S.I., Miroshkina L.V., Semenova G.F., Samokhina I.V., Kapustina E.Y., Dukhova Z.N., Potapov A.S., Petrichuk S.V.
Abstract
Aim: The purpose of the study was to assess mitochondrial dysfunction severity in patients with hepatic forms of glycogen storage disease (GSD). Patients and methods: We examined 53 children with GSD in the dynamics. Distribution of children by disease types was: 1st group — children with GSD type I, 2nd group — children with GSD type III, 3rd group — children with GSD type VI and IX; comparison group consisted of 34 healthy children. Intracellular dehydrogenases activity: succinate dehydrogenase (SDH), glycerol-3-phosphate-dehydrogenase (GPDH),
nicotinamideadenin-Н-dehydrogenase (NADH-D) and lactatdehydrogenase (LDH) was measured using the quantitative cytochemical method in the peripheral lymphocytes. Results: It was revealed decrease of SDH- (р <0.001) and GPDH-activities (р <0.001), along with increase of the NADH-D activity (р <0.05) in all patients with GSD, (SDH / NADH-D) index was decreased (р <0.001). LDH activity was increased in groups 1 (р <0.05) and 3 (p <0.01), compared with comparison group. The most pronounced intracellular enzymes activity deviations were observed in children with GSD type I, that correspond to more severe clinical form of GSD. It was found strong correlation between intracellular enzymes activity and both hepatomegaly level (R =0.867) and metabolic acidosis severity (R =0.987). Conclusion: Our investigation revealed features of mitochondrial dysfunction in children with GSD, depending on the GSD type. Activities of lymphocytes enzymes correlates with the main disease severity parameters and can be used as an additional diagnostic criteria in children with hepatic form of GSD.

Annals of the Russian academy of medical sciences. 2014;69(7-8):78-84
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PHARMACOLOGY: CURRENT ISSUES
NEW APPROACHES IN THE REGULATION OF BLOOD PHAGOCYTES AND REDUCTION IN THE FORMATION OF OXYGEN RADICALS IN PATIENTS WITH HEART FAILURE
Astashkin E.I., Glezer M.G., Vinokurov M.G., Orekhova N.S., Egorova N.D., Novikova A.N., Yurinskaya M.M., Grachev S.V., Sobolev K.E.
Abstract
Aim: The purpose was to study the effect of actovegin on the formation of reactive oxygen species by blood phagocytes of patients with heart failure
and on SK-N-SH neuron necrosis. Materials and methods: The generation of superoxide anion (O2-•) were recorded on whole blood samples (50–100 μl). Change lucigenin-dependent hemiluminescence determined on a hemi-luminometer «Biotoks-7». As a stimulator of the phagocyte phorbol ester (PMA, 1 μm) was used. Necrosis of neurons induced by hydrogen peroxide was determined by fluorescence of propidium iodit. Results: Blood phagocytes of heart failure patients are initially pre-activated (primed). These cells spontaneous generated oxygen radicals. Actovegin dosadependent decreased radicals level and radical induced by PMA (1 μm). After PMA maximal inhibitory effect of actovegin observed in doses higher than 2–3 mg/ml. The impact of actovegin on the viability of human SK-N-SH neurons in the presence hydrogen peroxide (100 μm) was studied in
vitro. Under these conditions hydrogen peroxide triggered radical-dependent neurons necrosis Actovegin dosa-dependent decreased of neuron death.
Conclusion: Actovegin inhibits spontaneous and induced formation of reactive oxygen species generated by blood phagocytes of patients with heart failure. Actovegin suppressed necrosis of human SK-N-SH neuroblastoma cells caused by hydrogen peroxide. It is assumed that actovegin protects cells of various organs and tissues, including blood cells and neurons that die as a result of ischemia and inflammation by reducing levels of reactive oxygen species.

Annals of the Russian academy of medical sciences. 2014;69(7-8):100-105
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SHORT MESSAGES
GRADIENT OF MORTALITY OF PERSONS AGED 40–59 IN REGIONS OF THE RUSSIAN FEDERATION
Boitsov S.A., Samorodskaya I.V., Tret'yakov V.V.
Abstract
Aim: The purpose of the study was to evaluate the differences and factors that are interlinked with mortality rates of the population aged 40–59 years in the subjects of the Russian Federation. Materials and methods: To calculate mortality rates used by Rosstat data on population and number of deaths in the age groups 40–59 years among men and women in the regions of Russia, as well as indicators that characterize the socioeconomic condition of the region. Results: In the Russian Federation there is a significant mortality gradient between the regions, and among male and female population aged 40–59. Except in certain republics of the North Caucasus, mortality among male and female population in the other regions of the Russian Federation is significantly higher than in Moscow. There was a statistically significant correlation of medium strength (r =0.6; p <0.0001) between the mortality rates (both men and women ) and indicators such as the sale of vodka, liqueurs and brandy (liters per person) per capita of working age and older people. Correlation between mortality and indicators reflecting the level of life in the regions was weaker or not detected at all. Conclusion: For an accurate assessment of the factors influencing mortality gradient in regions longitudinal cohort studies are needed to be carry out.

Annals of the Russian academy of medical sciences. 2014;69(7-8):106-111
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COMPARATIVE ANALYSIS AND CLINICAL EXPERIENCE WITH OSTEOPLASTIC MATERIALS MATERIALS BASED ON NON-DEMINERALIZED BONE COLLAGEN AND ARTIFICIAL HYDROXYLAPATITE AT THE CLOSE OF BONE DEFECTS IN AMBULATORY SURGICAL DENTISTRY
Dunaev M.V., Kitaev V.A., Motavkina M.V., Druzhinina A.E., Bubnov A.S.
Abstract
Background: In the presence of bone defects during surgery is not always performed osteoplastic material replenishment defect that leads to a lengthening of the timing healing, bone regeneration, and treatment outcome. Application of osteoplastic materials allows for faster treatment outcomes, accelerate the regeneration of bone tissue in the area of the defect. Aim: To examine the effectiveness of materials based on non-demineralized bone collagen and artificial hydroxylapatite when filling bone defects in outpatient surgical practice dentistry. Patients and methods: 22 patients with bone defects of various localization using osteoplastic materials were examined and treated. In our study, two groups were allocated on the etiology of bone loss: radicular cysts and chronic generalized periodontitis. Basic methods of diagnosis and monitoring of treatment in the work presented with the cone-beam computed tomography and digital orthopantomography. Results: Application of the testing osteoplastic materials resulted in faster recovery times with a combination of bone defects using resorbable membranes or gel enriched fibrin. In all 22 patients both tested materials were well tolerated, allergic reactions were not identified. However, five patients with a history of endocrinological history, during which treatment material is applied on the basis non-demineralized bone collagen, the degree of osseointegration has been reduced by 25% compared to the somatic healthy patients. In 3 patients with a history of hematological history, during which the treatment was applied material on the basis of artificial hydroxyapatite, the regeneration of the bone defect was reduced by 20%, which suggests the influence of somatic condition of the patient on the regeneration of bone tissue. Currently, all patients are on dynamic monitoring, recurrence has been detected. Conclusion: Materials based on nondemineralized bone collagen and hydroxyapatite artificial equally successful during the replacement of the bone defect during surgery. However, the degree of regeneration may be different if the patient has a history of aggravated that should be considered when planning treatment.

Annals of the Russian academy of medical sciences. 2014;69(7-8):112-120
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MORTALITY OF WORKING AGE POPULATION IN RUSSIA AND INDUSRIAL COUNTRIES IN EUROPE: TRENDS OF THE LAST TWO DECADES
Izmerov N.F., Tikhonova G.I., Gorchakova T.Y.
Abstract
Aim: The purpose of the study was to carry out comparative analysis of the status and trends in mortality of male and female population of working age (15–59 (54) years) in Russia and the EU-27. Materials and methods: Based on official Russian (Rosstat) data, on the global database of the World Health Organization’s cause of death (The WHO Mortality Database, WHOMD) and databases The Human Mortality Database (HMD) of the sex-age composition of the population and the number of deaths from certain causes of death by age and sex standardized (direct method) mortality rates of working age population from selected causes of death for 1990 and 2011 in Russia and the average for the EU-27 were calculated. Results: Analysis of trends in mortality of male and female population of working age in Russia over the past two decades shows that, despite the positive changes in during last six years, in 2011, age-standardized mortality rates remained above the 1990 level for most causes of death. During the same period in the EU-27 mortality in men (15–59 years) and women (15–54 years) increased from almost all causes of death, which led to an even greater gap between Russia and developed countries on this indicator: standardized mortality rate of the male population of Russia in 1990 was higher than in the EU-27 by 2.1 times, and by 2011 the gap had increased to 3.5 times. The women in the 1990 had 1.5 times higher standardized mortality rates, and by 2011 the gap had increased to 2.7 times. Conclusion: Despite a steady decline in the mortality rates of working age population after 2005, its level in 2012 was still higher than the one of 1990 for both men and women, which led to a further increase in the gap between the age-standardized coefficients of mortality rate of working age population in Russia and the countries of European Community-27 (15–59 (54)). Faster reduction of mortality rate in the working age population will preserve Russian population and its labor potential.

Annals of the Russian academy of medical sciences. 2014;69(7-8):121-126
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FRACTURE HEALING UNDER INTRAMEDULLARY INSERTION OF WIRES WITH HYDROXYAPATITE COATING
Ir'yanov Y.M., Kir'yanov N.A., Popkov A.V.
Abstract
Aim: To study morphological features of the bone formation process in consolidation of fractures of long tubular bones in conditions of intramedullary wires insertion with bioactive calcium-phosphate coating of hydroxyapatite. Materials and methods: In experimental study in dogs was simulated open comminuted tibia fracture and performed intramedullary insertion of wires with hydroxyapatite coating. Using light and electron microscopy, using X-ray electron microprobe microanalyses were studied bone regenerates in 14–360 days after surgery. Results: It was found that around wires there is a formation of an area of active reparative bone formation and angiogenesis, bone shaped case with the properties of the conductor and inducer of osteogenesis. Fracture consolidation is carried out in the early stages of the primary type without formation of cartilage and connective tissue in the bone adhesion. Conclusion: Study results testify that intramedullary wires with hydroxyapatite coating positively influence on the process and intensity of reparative bone formation in fracture healing.

Annals of the Russian academy of medical sciences. 2014;69(7-8):127-132
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ROLE OF DYSLIPIDEMIA IN PATHOGENESIS OF VASCULAR EVENTS AMONG ARCTIC CIRCLE POPULATION
Maslov L.N., Vychuzhanova E.A., Gorbunov A.S., Tsibul'nikov S.Y.
Abstract
Habitation within the polar circle increases cardiovascular mortality rate and particularly increases mortality as a result of coronary events. The main reason of elevation of mortality from these diseases is a dyslipidemia which developed more among alien population residing long time in Far North. Dyslipidemia is less found among aboriginal population of Arctic Circle keeping traditional way of life and respectively it is low rate of mortality from coronary heart disease. The data showed that low rate of dyslipidemia among aboriginal population of North regions depends on fish consumption which is high content of ω3-polyunsaturated fatty acids.

Annals of the Russian academy of medical sciences. 2014;69(7-8):133-136
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STIMULATION OF PELVIC FRACTURE HEALING BY LOCAL INJECTION OF AUTOLOGOUS PLASMA IN COMBINATION WITH METABOLICALLY ACTIVE SUBSTANCES THAT HAVE AN ANTIOXIDANT AND ANTIHYPOXIC EFFECT
Silant'eva T.A., Krasnov V.V.
Abstract
Aim: The study was aimed at performing an experimental trial of the reparative osteogenesis stimulation by local injection of autologous
plasma in combination with metabolically active substances such as L-ascorbic acid and D-glucose for management of pelvic fractures.
Material and methods: The experiment was carried out on twenty-six mongrel dog of both sexes aged 1.5±0.09 years and with body weight
of 17±0.5kg. Transverse osteotomy was performed in the acetabulum (n =20) and in the ilium body (n =6).The fractures were stabilized with external fixators. On days two through 5 after the operation all dogs had intraarticular or intraosseous injections of the saline solution throughout 24 hours in the dose of 0.4 ml per day. Experimental animals were additionally injected once a day with 1 ml of a composition consisting of the ascorbic acid and glucose. The external apparatuses were dismounted on day 21 after the operation. The animals for histological study were euthanized on day
14 and 42 after the operation. The study used radiographic and histological methods of study as well as the method of radiographic electron probe
microanalysis. Results: The control animals that had either intraosseous or intraarticular saline injections alone had fibro-cartilaginous union of the
pelvic fragments. They developed bone deformity due to secondary displacement upon apparatus removal. The experimental animals had primary bone union on day 14. The bone was consolidated after the removal of the apparatus. Conclusion: Autologous blood plasma in combination with active substances of ascorbic acid and glucose had a marked stimulating effect on pelvic fracture healing if applied locally in the posttraumatic period. The method of reparative osteogenesis stimulation that was developed is low traumatic. It does not hinder early functional loading and allows control of reparative process basing on the biological principles of tissue regeneration.

Annals of the Russian academy of medical sciences. 2014;69(7-8):137-143
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THE PROBLEMS OF EXPERTISE OF BIOMEDICAL PROJECTS AND ASSIGNING THEM STATUS OF BREAKTHROUGH AND WORLD-CLASS
Starodubov V.I., Kurakova N.G., Tsvetkova L.A., Kupriyanova O.I., Kuznetsov S.L.
Abstract
There was a sharp increase in the number of scientific fields, research fronts, publications and patents in biomedicine in the last five years, which
complicates the work of the experts on the selection of projects for priority funding. The approaches to the identification of perspective directions
of research used in the world were examined. An attempt was made of formalization of the concepts of «breakthrough research» and «world level
research» in relation to the Russian biomedical projects. The rationale for information support of expert decision-making about the prospects of development of individual areas of research in biomedicine is outlined.

Annals of the Russian academy of medical sciences. 2014;69(7-8):144-152
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PROBLEMS OF DEPRESSIVE INSOMNIA
Tarakanova E.A., Ivanchuk E.G., Rostovshchikov V.V.
Abstract
Aim: To evaluate the efficacy and safety of antidepressant agomelatine in relation to the normalization of circadian rhythms in a psychiatric outpatient practice. Patients and methods: It was an open label, non-comparative observational study of 32 patients 18–55 years during the eight-week therapy of major depressive episode mild or moderate severity. For statistical analysis the obtained results were used software package Excel 97. Results: On the background of treatment marked improvement in levels of depression and decreased intra-group scores of the indicators of the scale of Leeds. A statistically significant increase in the proportion of responders and remitters is achieved already in the first 2 weeks of therapy. Conclusion: Thus, in the course of the study, it was shown that along with antidepressant effects, agomelatine able to synchronize disturbed circadian rhythms and to correct sleep disorders in patients with depression.

Annals of the Russian academy of medical sciences. 2014;69(7-8):153-157
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