Introduction. Flaviviruses, possessing natural neurotropicity could be used in glioblastoma therapy using attenuated strains or as a delivery system for antitumor agents in an inactivated form. Objective. To investigate the sensitivity of glioblastoma and pancreatic carcinoma cell lines to vaccine strains of yellow fever and tick-borne encephalitis viruses. Materials and methods. Cell lines: glioblastoma GL-6, T98G, LN-229, pancreatic carcinoma MIA RaCa-2 and human pancreatic ductal carcinoma PANC-1. Viral strains: 17D yellow fever virus (YF), Sofjin tick-borne encephalitis virus (TBEV). Virus concentration were determined by plaque assay and quantitative PCR. Determination of cell sensitivity to viruses by MTT assay. Results. 17D YF was effective only against pancreatic carcinoma tumor cells MIA Paca-2 and had a limited effect against PANC-1. In glioblastoma cell lines (LN229, GL6, T98G), virus had no oncolytic effect and the viral RNA concentration fell in the culture medium. Sofjin TBEV showed CPE50 against MIA Paca-2 and a very limited cytotoxic effect against PANC-1. However, it had no oncolytic effect against glioblastoma cell lines (LN229, T98G and GL6), although virus reproduction continued in these cultures. For the GL6 glioblastoma cell line, the viral RNA concentration at the level with the infection dose was determined within 13 days, despite medium replacement, while in the case of the LN229 cell line, the virus concentration increased from 1 × 109 to 1 × 1010 copies/ml. Conclusion. Tumor behavior in organism is more complex and is determined by different microenvironmental factors and immune status. In the future, it is advisable to continue studying the antitumor oncolytic and immunomodulatory effects of viral strains 17D YF and Sofjin TBEV using in vivo models.

Introduction. A significant proportion of patients hospitalized due to decompensation of liver cirrhosis have some kind of renal dysfunction (acute kidney injury, hepatorenal syndrome, chronic kidney disease). However, their effect on mortality in cirrhosis has been little studied. Aim. The aim of the research was to study the role of renal dysfunction in fatal outcomes in cirrhosis. Material and methods. The retrospective cohort study was conducted, which included patients with a confirmed diagnosis of cirrhosis hospitalized in the hepatological department and/or the department of anesthesiology-intensive care of City Clinical Hospital No. 1 of the Ministry of Health of Chuvashia in 2014-2018. The medical histories of patients were retrospectively studied. The conclusions of pathoanatomic autopsies were analyzed in deceased patients. At the same time, demographic indicators, etiological factors of cirrhosis, the degree of compensation on the Child-Pugh scale, complications and causes of deaths were taken into account. The results of instrumental studies, laboratory tests were also considered. Particular attention was paid to the study of the frequency of occurrence of various types of renal dysfunction. Potential risk factors for death of patients were determined using a one-dimensional regression analysis. Results and discussion. During 5 years from 2014 to 2018, 634 patients with cirrhosis decompensation received inpatient treatment with a total number of hospitalizations equal to 1,672. During the first hospitalization, 140 patients died, which is 22.1% of the total number of patients. The average age of the deceased patients was 51.4±13.6 years. Alcoholic liver disease prevailed in the etiological structure of fatal cirrhosis (in 35.7% of cases). Hospital mortality was associated in 74.2% of cases with renal dysfunction. Patients with cirrhosis decompensation died most often (26.4 %) from prerenal acute kidney injury. The fatal outcome in cirrhosis was more dependent on indicators characterizing the functional state of the kidneys (serum levels of urea, creatinine, glomerular filtration rate), the hemostasis system (prothrombin index), and to a lesser extent on indicators characterizing the functional state of the liver. Conclusion. Fatal outcomes in cirrhosis were associated in 74.2% of cases to some extent with renal dysfunction.

Liver cirrhosis continues to be an acute problem of modern medicine due to the high rates of its prevalence and mortality. The high mortality rate is caused by the development of the number of life–threatening complications in decompensated forms of liver cirrhosis – hepatorenal syndrome, infections and varicose bleeding. Hepatorenal syndrome and infections are the result of immunological shifts occurring during decompensation of liver cirrhosis. Currently available literature data do not allow us to create a complete picture of the functional state of various links of adaptive immunity with decompensated liver cirrhosis. The aim of the research was to study the characteristic features of adaptive immunity in patients with decompensated liver cirrhosis. Material and methods. The prospective cohort study included 136 patients with decompensated liver cirrhosis, who received inpatient treatment in the hepatological department of the multidisciplinary hospital. The cohort of examined patients was divided into two groups, one of which included patients with liver cirrhosis of viral origin (n = 78), the other – patients with alcoholic liver cirrhosis (n = 58). In addition to the generally accepted standard methods, the patient examination program included immunological tests: identification of T- and B-lymphocytes, immunoregulatory and activated subpopulations of T-lymphocytes by the method of immunophenotyping peripheral blood mononuclear cells using monoclonal antibodies. The serum levels of immunoglobulins IgM, IgG, IgA, circulating immune complexes were determined by immunoturbidimetric method. Results. The study of indicators of the humoral link of adaptive immunity revealed an increase in the number of B cells, an increase in IgM, IgG, IgA and circulating immune complexes in patients with decompensated liver cirrhosis. The cellular link of adaptive immunity was characterized by an increase in the relative content of T helper cells, activated T cells against the background of a decrease in the number of immature T cells and T regulatory cells. Conclusions. The distinctive features of adaptive immunity in patients with decompensated liver cirrhosis are simultaneous activation of both humoral and cellular components, which, apparently, supports the systemic inflammatory process and the associated progressive liver fibrosis.

В статье представлено собственное наблюдение течения беременности и родов у пациентки с чистой формой дисгенезии гонад (кариотип 46, ХХ). Диагноз установлен в 16 лет при комплексном обследовании по поводу первичной аменореи, проводилась заместительная гормональная терапия. Беременность наступила после подготовки эндометрия эстрогенами и гестагенами на фоне инфузии иммуноглобулинов в результате третьей попытки экстракорпорального оплодотворения с донорской яйцеклеткой (от родной сестры) и спермой мужа, протекала с угрозой прерывания — с кровянистыми выделениями на фоне носительства анти-β2-гликопротеиновых антител и гиперкоагуляции. В 36—37 нед вступила в роды, в связи с чем родоразрешена путем операции кесарева сечения.

The studies on the use of municipal wastewater sludge as an unconventional chemical ameliorant with a fertilizing effect were carried out on ore dressing waste ("tailings") of the apatite-nepheline plant ANOF-2 KF JSC "Apatit" with a predominance of nepheline sands in their composition. The tailings dump is included in the list of objects of accumulated environmental damage in the region, but due to its rich mineral composition, it is recognized as a technogenic deposit subject to conservation for the prospect of obtaining apatite, nepheline, sphene, aegirine and titanomagnetite concentrates. In the work, the method of phytotesting of soil irrigated with unfiltered rainwater with fragmentary application of sewage sludge of a regional wastewater treatment plant enterprise has been applied. The experiments have been carried out on a single-species seed recommended for reclamation of disturbed territories in the northern regions. During the formation of a sown phytocenosis from meadow timothy (Phleum pratense L.) on nepheline sands, the stimulating effect of sewage sludge on the nutrient regime of the soil is confirmed. After phytoextraction (at the end of the experiment), it retains a high residual pool of basic nutrients (N, P, K), which indicates a prolonged action of sewage sludge. To confirm the effect obtained in laboratory conditions, a field experiment has been laid at the ANOF-2 reserve tailing dump in 2019, observations are continuing.

The article highlights the results of a study of a new method for diagnosing non-alcoholic fatty liver disease in a living organism by determining the serum level of the marker Secreted frizzled related protein-4 (SFRP4) with histological confirmation of the results. In a chronic experiment, the parameters of two groups of experimental animals were studied: control and experimental, 15 rats each. The control (reference) group of animals was in the usual feed and drinking mode, the experimental received food with a high content of carbohydrates and fats. The results of biochemical blood tests and autopsy biomaterials on day 180 of the experiment indicated the presence of fatty changes in the liver in the experimental group of animals. The importance of circulating adipokine SFRP4 in the diagnosis of non-alcoholic fatty liver disease (NAFLD) has been confirmed. A histologically confirmed direct correlation of SFRP4 with the degree of liver fibrosis in NAFLD was revealed. The place of SFRP4 in the pathogenesis of non-alcoholic fatty liver damage is explained. It is noted that in case of successful extrapolation of the results of the study on the human body, information will become a successful solution to one of the most pressing problems of modern hepatology.

Although circulating microRNAs (miRNAs) in maternal blood may play an important role in regulation of pregnancy progression and serve as non-invasive biomarkers for different gestation complications, little is known about their profile in blood during normally developing pregnancy. In this study we evaluated the miRNA profiles in paired plasma and serum samples from pregnant women without health or gestational abnormalities at three time points using high-throughput sequencing technology. Sequencing revealed that the percentage of miRNA reads in plasma and serum decreased by a third compared to first and second trimesters. We found two miRNAs in plasma (hsa-miR-7853-5p and hsa-miR-200c-3p) and 10 miRNAs in serum (hsa-miR-203a-5p, hsa-miR-495-3p, hsa-miR-4435, hsa-miR-340-5p, hsa-miR-4417, hsa-miR-1266-5p, hsa-miR-4494, hsa-miR-134-3p, hsa-miR-5008-5p, and hsa-miR-6756-5p), that exhibit level changes during pregnancy (p-value adjusted < 0.05). In addition, we observed differences for 36 miRNAs between plasma and serum (p-value adjusted < 0.05), which should be taken into consideration when comparing the results between studies performed using different biosample types. The results were verified by analysis of three miRNAs using qRT-PCR (p < 0.05). The present study confirms that the circulating miRNA profile in blood changes during gestation. Our results set the basis for further investigation of molecular mechanisms, involved in regulation of pregnancy, and the search for biomarkers of gestation abnormalities.

BACKGROUND: Perinatal death is the death of the fetus, starting from 22 weeks of pregnancy and in childbirth, as well as the death of a newborn in the first seven days of life. Despite the fact that reducing perinatal losses is one of the most important tasks of contemporary medicine, the level of perinatal mortality in Russia in recent years has been about 7.5 . AIM: The aim of this study was to analyze documentation related to the legal aspects of perinatal loss. MATERIALS AND METHODS: The article analyzes the main federal laws, agency regulations, orders, methodological letters, recommendations, and materials on the Internet concerning the main aspects and questions that most often arise among doctors, as well as postpartum women who have undergone perinatal loss and their family members. RESULTS: The article provides data on: the medical criteria for birth, basic documentation issued in case of stillbirth, the birth of a live child who died in the perinatal period, and the rules for their issuance; the rules and procedure for notifying state bodies in case of perinatal death, the rules for registering a stillborn and a child who died in the first 168 hours of extrauterine life; the types of perinatal death certificate; the rules for conducting a pathological autopsy and the possibility of refusing it; the issues of burial of children who died perinatally; the rules for handling material obtained during termination of pregnancy up to 22 weeks. CONCLUSIONS: The legislative framework was analyzed and answers were given to the most frequently asked questions regarding the legal aspects of perinatal loss.

Актуальность. Уровень перинатальной смертности является комплексным показателем социального благополучия, экономического развития и состояния медицинской помощи любого государства. Цель — исследовать динамику перинатальных потерь в Санкт-Петербурге и Ленинградской области за 2006–2018 гг. для определения резервов их снижения. Материалы и методы исследования. Были проанализированы региональные статистические отчеты по перинатальной смертности по Санкт-Петербургу и Ленинградской области за 2006–2018 гг. Результаты исследования. Проведен ретроспективный анализ динамики перинатальных потерь в Санкт-Петербурге и Ленинградской области. Рассмотрена структура перинатальных потерь по массе плода/новорожденного. Определена доля детей, погибших перинатально, в общем количестве умерших до достижения 18-летнего возраста. Выявлены основные резервы снижения перинатальной смертности. Выводы. При отчетливой тенденции к снижению перинатальной смертности в Санкт-Петербурге и Ленинградской области в исследуемый период абсолютное количество мертворождений остается на прежнем уровне.

The purpose of the research is to study the informativeness of the technology of Controlled Attenuation Parameter (CAP) in Shear Wave Elastography (SWE) in determining the degree of severity of liver steatosis depending on the elastometric quantitative values of liver fibrosis in a one-time study in a given volume of parenchima liver in patients with non-alcoholic fatty liver disease (NAFLD).Materials and methods of research. The study included 169 patients with NHTSA between the ages of 19 and 81, the average age was 41.7 ±11.3 years, examined in the “City Clinical Hospital No. 1” of the Ministry of Health, Chuvashia (Cheboksary, Russia). Patients with functional disorders of bile evacuation (n= 72) were the first group; the 2nd group were the patients with liver steatosis without manifestations of liver fibrosis (n = 28); the 3rd contained the patients with cirrhosis of the liver (n = 25); patients with chronic viral hepatitis B and C (n= 44) were in the 4th group. All patients were screened with ultrasonic shear wave elastography with elastometry in one-dimensional (TE) (FibroScan 502 TOUCH, France) and two dimensional (2DSWE) modes (Aixplorer, Supersonic Imagine, France). Elastometry (kPa) and steatometry (dB/m) were completed simultaneously within the same volume of the analyzed liver tissue with two sensing devices of “FibroScan 502 TOUCH”. The statistical processing was carried out with the help of IBM SPSS Statistics 10.0. The results are reflected in the form of median (Me), minimum (min), maximum (max) and medium (Emean) values, standard deviation (SD) of Jung’s elasticity module. Correlational analysis of the received values of parameters F and S was made with the descriptive method of Bland-Altman and the method of Spearman.Results and discussion. The average quantitative values of the severity of liver steatosis in patients with cirrhosis of liver had reliably lower values (234.5±62.1 dB/m) than in those suffering from steatosis of the liver without fibrosis (347.5±37.6 dB/m) and patients with chronic viral hepatitis (245.9±57.3dB/m, p lt; 0.001). The values of fibrosis in the same amount of the tested liver tissue with liver cirrhosis (45.5± 22.3 kP) were higher than similar rates in the other groups of patients with NAFLD (p lt; 0.001). Diagnostic informational content of the method of controlled ultrasound attenuation in establishing the degree of manifestation of liver steatosis had a higher specificity with II degree of liver steatosis (99.29% with a sensitivity of 84.92%).The results of the study allow us to recommend ultrasound elastography with the technology of controlled ultrasound attenuation to determine the severity of liver steatosis for both primary diagnosis and for dynamic monitoring of the liver condition of patients with NAFLD.

The immunomodulatory properties of immunobiological drugs Glutoxim and Phosprenyl we well as vesicular stomatitis virus and inactivated tick-borne encephalitis vaccine virus were studied using human diploid fibroblast cell line from the collection of M. P. Chumakov Federal Research Center for Research and Development of Immunobiological Products. All tested preparations exhibited immunomodulatory activity in human diploid fibroblast cell line. Glutoxim in doses of 0.1 and 0.25 μg/ml stimulated production of IL-6 and IL-10 during 24-48 h of culturing, but did not stimulate production of IL-1β. Phosprenyl, on the contrary, increased production of IL-1β and the levels of IL-6 and IL-10. Vesicular stomatitis virus stimulated the production of IL-1β, IL-6, and IL-10, while inactivated tick-borne encephalitis vaccine virus stimulated the production of cytokines IL-8 and IL-18. Immunomodulatory activity of inactivated tick-borne encephalitis vaccine virus was first demonstrated in the in vitro system.

Hypothesis/aims of study. The perinatal mortality rate is a comprehensive indicator of social well-being, economic development and the state of medical care in any country. The aim of this study was to analyze perinatal loss dynamics in St. Petersburg and the Leningrad Region for 2006-2018 so as to determine the reserves for the reduction of perinatal mortality. Study design, materials and methods. Regional statistical reports on perinatal mortality in St. Petersburg and the Leningrad Region for 2006-2018 were analyzed. Results. A retrospective analysis of perinatal loss dynamics in St. Petersburg and the Leningrad Region was carried out. The structure of perinatal losses by birth weight of the fetus / newborn was surveyed. The proportion of children who died perinatally in the total number of deaths before reaching the age of 18 was determined. The main reserves for reducing perinatal mortality have been identified. Conclusion. With a clear tendency for perinatal mortality in St. Petersburg and the Leningrad Region to decrease during the study period, the absolute number of stillbirths does not show such a tendency.

Цель. Оценить частоту осложнений беременности у женщин с сахарным диабетом 1-го типа и без сахарного диабета в сочетании с мочевой инфекцией и влияние различных вариантов терапии мочевой инфекции на частоту осложнений беременности при сахарном диабете 1-го типа. Методы. Обследованы беременные с мочевой инфекцией: 110 человек с сахарным диабетом 1-го типа (основная группа) и 133 женщины без диабета (группа сравнения). Диагноз мочевой инфекции подтверждали двукратным бактериологическим посевом. Пациентки основной группы были разделены на три подгруппы в зависимости от метода лечения мочевой инфекции: подгруппа А получала антибиотикотерапию и фитопрепарат (золототысячника трава + любистока лекарственного корень + розмарина обыкновенного листья), подгруппа Б — антибиотикотерапию, подгруппа В — фитопрепарат. После лечения оценивали сохранение осложнений беременности, развившихся на фоне мочевой инфекции, таких как угроза выкидыша, протеинурия, внутриутробное инфицирование плода, анемия, преждевременные роды. Достоверность различий в группах оценивали с помощью критерия χ2 Пирсона, эффективность каждого вида терапии — посредством критерия Мак-Немара. Результаты. Частота угрозы выкидыша, внутриутробного инфицирования, анемии и преждевременных родов оказалась выше у беременных основной группы при всех вариантах мочевой инфекции, пре­эклампсии — при пиелонефрите и бессимптомной бактериурии. Как комплексная терапия пиелонефрита (антибиотики с фитопрепаратом), так и монотерапия антибиотиками оказались эффективны в устранении угрозы выкидыша, внутриутробного инфицирования и анемии. Добавление фитопрепарата к антибиотикотерапии при пиелонефрите снижало частоту преждевременных родов по сравнению с монотерапией антибиотиком, по другим осложнениям различия между подгруппами не выявлены. При бессимптомной бактериурии комплексная терапия и монотерапия антибиотиком были эффективны в устранении угрозы выкидыша, внутриутробного инфицирования, анемии. Монотерапия фитопрепаратом у беременных с сахарным диабетом 1-го типа не приводила к ликвидации данных осложнений. Комплексная терапия бессимптомной бактериурии оказалась эффективнее монотерапии антибиотиком в отношении влияния на преждевременные роды и равно эффективна в плане угрозы выкидыша, внутриутробного инфицирования и анемии. Вывод. Добавление фитопрепарата к антибиотикотерапии при пиелонефрите и бессимптомной бактериурии у беременных с сахарным диабетом 1-го типа с целью профилактики преждевременных родов представляется целесообразным; монотерапия бессимптомной бактериурии фитопрепаратом неэффективна для устранения угрозы выкидыша, внутриутробного инфицирования, анемии, поэтому антибиотики следует назначать на старте терапии бессимптомной бактериурии.

In this study was made an attempt to reveal additional laboratory markers of white blood for preliminary estimation level of HIV-infection development. Essentially such markers these are in progress without complex equipment and expensive reagent. It was studied alterations of basic values cells of innate and acquired immunity of peripheral blood HIV-infected individuals with and without antiretroviral treatment (ART) during infection. It was estimate value leukocytes, neutrophils, monocytes, lymhpocytes, T-lymhpocytes, CD4+, CD8+ T-cells, CD4/CD8 index. It was used the first analysis in the time of registration for regular medical check-up and the intermediate derived during 2017-2018 years. Patients without ART and with ART before and after treatment had rates of leukocytes, lymhpocytes, T-lymhpocytes, monocytes and neutrophils within the normal guideline. Essential changes were observed in basic conventional laboratory parameters evaluation of HIV-infection dynamic (parameters of CD4+, CD8+ T-cells, CD4/CD8 index). Thereby it was impossible to reveal supplementary immunological markers of HIVinfection.

Hypothesis/aims of study. Prevention of the most common causes of perinatal mortality provides an opportunity to reduce perinatal losses. It is customary to distinguish between maternal, fetal and placental factors, dividing them into preventable and unavoidable subfactors. Of all nosologies, intrauterine hypoxia and asphyxia of the newborn, infectious (viral and / or microbial) damage to the placenta and fetus / newborn, and placental insufficiency (acute and chronic) are most important. The aim of this study was to analyze perinatal losses most often diagnosed in Saint Petersburg and the Leningrad Region in order to assess the possibility of developing a set of measures to reduce perinatal mortality. Study design, materials and methods. The analysis of perinatal losses in Saint Petersburg and the Leningrad Region in 20062018 is based on the official reports of the Saint Petersburg State Budgetary Healthcare Institution Medical Information and Analytical Center and the Leningrad Regional State Budgetary Healthcare Institution Medical Information and Analytical Center, as well as the reports of the Leningrad Regional Pathological and Anatomical Bureau (LRPAB). Results. The main causes of perinatal losses in Saint Petersburg and the Leningrad Region for 20062018 were: fetal hypoxia (acute and chronic), intrauterine infections, respiratory distress syndrome (for premature babies), congenital malformations, and chromosomal abnormalities. Throughout the period, intrauterine hypoxia and asphyxia of the newborn (which are the pathology manifestation, not etiology) were indicated as leading diagnoses in the conclusions of perinatal death. Moreover, according to the LRPAB pathomorphological findings, intrauterine infections were the leading (over 60% of cases) cause of perinatal losses over the years. During the analyzed period in Saint Petersburg and the Leningrad Region, a high frequency of individual states arising in the perinatal period remained unchanged without determination of a specific diagnosis, which significantly complicates our analysis. Conclusion. For an adequate diagnosis of the etiological mechanisms of perinatal losses, it is necessary to improve histological examination of the afterbirth and pathomorphological examination of the fetus / newborn using virological and immunological tests. It is also necessary to change the structure of statistical reports, obliging medical institutions to indicate the exact cause of perinatal death, excluding whenever possible the diagnoses of intrauterine hypoxia and asphyxia in labor that indicate no etiological diagnosis explaining the occurrence of hypoxia / asphyxia.

Актуальность. В последние 15 лет в статистических отчетах стандартно выделяют пять основных причин перинатальных потерь: гипоксию/асфиксию и ее последствия, врожденные пороки развития, респираторные нарушения, внутриутробные инфекции и родовые травмы. Причина перинатальных потерь указана в 17–83 % случаев, но этот показатель можно увеличить при тщательном анализе течения беременности, родов и результатов аутопсии. Цель — оценить частоту верификации причин перинатальной смерти в Санкт-Петербурге и Ленинградской области за 2006–2018 гг. Материалы и методы исследования. Была проанализирована методология установления причины перинатальных потерь в Санкт-Петербурге и Ленинградской области за 2006–2018 гг. по данным отчетов Санкт-Петербургского государственного бюджетного учреждения здравоохранения «Медицинский информационно-аналитический центр» и Ленинградского областного государственного бюджетного учреждения здравоохранения «Медицинский информационно-аналитический центр», а также Ленинградского областного патологоанатомического бюро. Проведена оценка частоты случаев, в которых данная причина не указана, в динамике за рассматриваемый период. Результаты исследования. Исследованы методология и проблемы, возникающие при установлении основных диагнозов: «внутриутробная гипоксия» (Р20.0), «асфиксия при родах» (Р21), «респираторные нарушения у новорожденных, возникшие в перинатальном периоде» (Р22–Р28), «геморрагические и гематологические нарушения у плода и новорожденного» (P50–P61). Представлено объяснение различий в частоте диагностики причин смерти в Ленинградском областном патологоанатомическом бюро — с помощью методики установления диагноза хронической плацентарной недостаточности (О43.8 — «Другие плацентарные нарушения: дисфункция, инфаркт»), основанной на обнаружении при вскрытии гипоксической кардиопатии, а также разработанного в организации подхода к выявлению внутриутробных инфекций. Оценена частота встречаемости случаев, в которых причина перинатальной потери не указана, объяснены причины и возможности данной ситуации. Выводы. Низкая информативность официальных статистических отчетов затрудняет анализ реальных причин перинатальных потерь.

The authors analyzed the State educational standard of higher professional education in the “Physical culture and sport” discipline, the working program on “Physical culture and sport” discipline in two universities in Samara and studied the scientific literature of local and foreign authors based on the research topic. The purpose of this study was to analyze the social significance and social functions of information and computer technologies in the educational process in the “Physical culture and sports” discipline. The study used the following empirical methods: observation, survey, questionnaire, practice tests. The following conclusions: the questionnaire offered to the students of these two universities confirmed the presence of the students’ interest in the introduction of information and computer technologies in educational process on physical training, which will increase the motivation to learning and doing sports activities in universities; authors marked significant social function of ICT in the process of “Physical culture and sport” discipline in a particular university.