Aim . To study the perioperative dynamics of myocardial injury biomarkers high-sensitivity cardiac troponin I (hs-cTnI), ischemia-modified albumin (IMA) and soluble ST2 (sST2) when taking nicorandil in lung cancer patients with concomitant coronary heart disease (CHD) undergoing surgical lung resection. Material and methods . The study included 54 patients (11 women and 43 men) with non-small cell lung cancer and concomitant stable CHD who underwent lung resection in the volume of lobectomy or pneumonectomy. Patients were randomly assigned to the nicorandil group (oral administration 10 mg BID for 7 days before and 3 days after surgery; n=27) and the control group (n=27). In the study groups, the perioperative dynamics of hscTnI, IMA and sST2, determined in the blood before and 24 and 48h after surgery, were compared. We calculated the incidence of acute myocardial injury in the groups, which was diagnosed in cases of postoperative hs-cTnI increase of more than one 99 th percentile of the upper reference limit. The associations of nicorandil intake and acute myocardial injury were evaluated. Results . The groups were comparable in gender, age, basic clinical characteristics, as well as baseline levels of myocardial injury biomarkers. After the intervention, both samples showed an increase in the hs-cTnI and sST2 levels and a decrease in IMA concentration (all p<0.02 for related group differences). In the nicorandil group, in comparison with the control one, 48h after surgery, we found lower mean levels of hs-cTnI [16.7 (11.9;39.7) vs 44.3 (15.0;130.7) ng/l; p<0.05) and sST2 [62.8 (43.6;70.1) vs 76.5 (50.2;87.1) ng/ml; p<0.05), concentration increase rates of hs-cTnI [14.8 (0.7;42.2) vs 32.5 (14.0;125.0) ng/l; p<0.01) and sST2 [24.4 (10.3;42.4) vs 47.4 (17.5;65.3) ng/ml; p<0.05), as well as highest concentrations for the entire postoperative period of hs-cTnI [30.7 (12.0;53.7) vs 79.0 (20.3;203.3) ng/L, p<0.01] and sST2 [99.8 (73.6;162.5) vs 147.8 (87.8;207.7) ng/mL; p<0.05]. The serum IMA decreased when taking nicorandil to a greater extent [-8.0 (-12.6; -2.0) vs -2.7 (-6.0; +5.5) ng/ ml; p<0.01] 24h after surgery. Acute myocardial injury was diagnosed in 7 people in the nicorandil group (25.9%) and in 15 in the control one (55.6%; pχ 2 =0.027). The adjusted odds ratio of acute myocardial injury when taking nicorandil was 0.35 (95% confidence interval 0.15-0.83, p=0.017). Conclusion . Taking nicorandil in patients with lung cancer and concomitant CHD who underwent surgical lung resection is associated with a lower postoperative increase in hs-cTnI and sST2 and a reduced risk of acute myocardial injury, which may indicate the cardioprotective effect of nicorandil under acute surgical stress conditions.

Aim. To study the perioperative dynamics of myocardial injury biomarkers and determine their significance in assessing the postoperative mortality risk in patients with nonsmall cell lung cancer.Methods. The study included 82 male patients with non-small cell lung cancer undergoing pneumonectomy. The median age was 64 (59; 67) years. The blood levels of cardiac troponin I (cTnI), N-terminal pro b-type natriuretic peptide (NT-proBNP) and fatty acid-binding protein (FABP) were noted before and after surgery. The rate of myocardial injury after non-cardiac surgery (MINS) was determined. The postoperative cTnI level above 0.023 μg/L was considered as MINS criterion. The significance of the studied biomarkers in predicting the total mortality within 6 months after surgery was assessed using the univariate and multivariate Cox regression and ROC analysis.Results. Compared to baseline levels, all myocardial injury biomarkers increased in 24 and 48h after surgery: cTnI by 120 and 85%, NT-proBNP by 128 and 129%, FABP by 207 and 31%, respectively. The postoperative cTnI levels met the MINS criterion in 45.1% of patients. During the follow-up period 12 patients died, 9 (75%) of those were diagnosed with MINS. Based on the results of the univariate Cox regression overall postoperative mortality was associated with NTproBNP levels before and after the surgery, cTnI growth rate after the surgery and MINS. According to the multivariate Cox regression (adjusted for age and other clinical parameters), preoperative NT-proBNP and atrial fibrillation proved to be the independent predictors of postoperative mortality. The cut-off value of preoperative NT-proBNP was 225 pg/mL; relative risk of death above that value was 5.9 and 95% confidence interval of 1.74–20.0.Conclusion. In patients with non-small cell lung cancer the increase of cTnI, NT-proBNP and FABP mean levels was observed in 24 and 48 hours after pneumonectomy. MINS was diagnosed in 45.1% of patients. According to the univariate regression analysis, MINS and preoperative and postoperative NT-proBNP levels were associated with the risk of total six-month postoperative mortality. The preoperative NT-proBNP was proved to be an independent predictor of adverse outcome.

Aim. To assess the significance of changes cystatin C-based estimated glomerular filtration rate (eGFRcys) in predicting inhospital mortality in patients with acute ST-segment elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PCI).Material and methods. In 133 patients with STEMI, serum creatinine and cystatin C were determined. Creatinine clearance (CrCl) was estimated according to Cockcroft-Gault equation. Creatinine-based estimated glomerular filtration rate (eGFRcr) was assessed using the MDRD (eGFRcr_MDRD) and CKD-EPI 2009 (eGFRcr_CKD-EPI). In addition, eGFRcys and a combination of serum creatinine and cystatin C (eGFRcr-cys) was assessed using the CKD-EPI 2012 equation at admission and 24-48 hours after PCI. In the groups of deceased patients and survivors, the studied parameters were compared. Their relationship with imhospital mortality was assessed by logistic regression adjusted for acute kidney injury (AKI) and GRACE risk. To assess the informativeness of identified independent predictors, an ROC analysis was performed.Results. After PCI, serum creatinine level increased by 9,8%, cystatin C — by 38,2%. CrCl decreased by 9,0%, eGFRcr_MDRD — by 10,2%, eGFRcr_CKD-EPI — by 5,2%, eGFRcys — by 29,5%, eGFRcr-cys — by 19,3%. AKI was diagnosed in 21 people (15,8%). Among the deceased patients (n=12), compared with the survivors, serum creatinine level was higher at baseline and after PCI, cystatin C — after PCI, eGFR of any calculation method was lower, while AKI developed more often. According to multivariate regression analysis, the eGFRcr-cys after PCI and the GRACE risk score were independent predictors of the endpoint. The area under the ROC curve for eGFRcr-cys after PCI was 0,835 [0,712-0,958], while the cut-off point was 38 ml/min/1,73 m2, below which the odds ratio of developing a fatal outcome was 22,2 with a 95% confidence interval of 5,7- 86,8.Conclusion. Estimated GFR determined 24-48 h after PCI based on the combination of serum creatinine and cystatin C using the CKD-EPI 2012 equation was an independent predictor of inhospital mortality in STEMI. The cut-off point of this parameter was 38 ml/min/1,73 m2, below which the death risk increases significantly. The results indicate the viability of introducing novel methods for assessing renal function based on cystatin C to improve the quality of prediction in STEMI.

The aim of the research. To study the biomarkers of inflammation in acute ST-elevation myocardial infarction (STEMI) in patients of the Buryat ethnic group in comparison with Russian patients. Material and methods. In 109 patients with acute STEMI of Buryat (n = 43) and Russian (n = 66) nationalities, as well as in 42 healthy donors (20 Buryats and 22 Russians), serum levels of high-sensitivity C-reactive protein, interleukin-1β (IL-1β ), interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-10 (IL-10) and tumor necrosis factor-α (TNF-α), as well as IL-6/IL-10 and IL-8/IL-10 ratios were evaluated and compared between the ethnic groups with consideration for the clinical data and STEMI severity, as well as in the groups of healthy patients and those with STEMI. Results. The study groups did not differ in gender and age. Compared to healthy subjects in the STEMI group, the concentration of all inflammation biomarkers was higher regardless of ethnicity, with the exception of IL-1β, which significantly increased in Caucasians only. According to the results of comparative analysis, patients with STEMI of the Russian group matched to that of the Buryat, had higher levels of IL-1β (1.46 [0.41-3.67] and 0.02 [0.01- 1.12] pg/ml, respectively), TNF-α (2.1 [1.4-3.0] and 0.9 [0.4-2.2] pg/ml), IL-6/IL-10 ratios (4.9 [3.5-7.8] and 3.4 [1.7-6.7]) and IL-8/IL-10 (37.6 [8.1-63.4] and 11.9 [5.8-30.7]), troponin T (2.5 [0.19-15.5] and 0.38 [0.11-2.7] ng/ml), creatine phosphokinase-MB (29.4 [17.3-89] and 19.0 [12-26] IU/l), and lower body mass index (24.9 [22.5-28.4] and 27.3 [25.1-31.0] kg/m2) and left ventricular ejection fraction (51.5% [44-57] and 55.0% [50-58]). After adjustment for gender, age, and body mass index, the association with ethnicity remained significant for IL-1β (F for the general regression model was 5.28; p = 0.024) and the IL-6/IL-10 ratio (F = 4.43; p = 0.037). Conclusion. The pro-inflammatory response against the background of STEMI in the Buryat ethnic group as compared to the Russian one is characterised by lower levels of IL-1β, TNF-α as well as lower IL-6/IL-10 and IL-8/IL-10 ratios. After adjustment for gender, age, and body mass index, differences in ethnic groups remained significant for IL-1β and IL-6/IL-10, which indicates a less pronounced proinflammatory response in STEMI patients of the Buryat nationality.

Aim. To investigate the relationship of soluble ST2 (sST2) to acute heart failure (AHF) and compare the predictive value of sST2 and brain natriuretic peptide in patients with ST-elevation myocardial infarction (STEMI).Material and methods. In 136 STEMI patients, the serum sST2 concentration was determined during the first 24 hours of hospitalization. We assessed levels of sST2, N-terminal pro-brain natriuretic peptide (NT-proBNP), incidence of Killip class II-IV AHF during hospitalization, myocardial necrosis biomarkers, parameters of complete blood count and biochemical blood tests, the incidence of cardiovascular diseases and risk factors. The predictive value of sST2 for AHF development was assessed using logistic regression. ROC analysis was performed. The areas under the ROC curve were compared for sST2 and NT-proBNP. The cut-off sST2 value was determined for predicting AHF.Results. The mean sST2 level was 43,4 (33,6-73,9) ng/ml. During the followup period, AHF was diagnosed in 54 people (39,7%). The prevalence of AHF in the 1st, 2nd and 3rd tertiles of sST2 was 15,6%, 33,3% and 69,7%, respectively. The NT-proBNP levels were 319 (128-1072) pg/ml, 430 (147-1140) pg/ml and 1317 (533-2386) pg/ml. The predictive value of 3rd sST2 tertile was retained adjusted for age, sex, NT-proBNP, troponin T, creatine phosphokinase-MB, high-sensitivity C-reactive protein, hemoglobin, blood glucose, left ventricular ejection fraction. The areas under the ROC curves for sST2 and NT-proBNP were comparable (0,828 and 0,733, respectively; p=0,056). The cut-off sST2 value was 64 ng/ml, above which the odds ratio of AHF was 11,1 (95% confidence interval, 4,7-26,1.Conclusion. An increase in blood sST2 is associated with an increase in AHF (Killip II-IV) prevalence in hospitalized patients with acute STEMI. Soluble ST2 has an independent predictive value for AHF in STEMI, comparable in strength and predictive model quality to NT-proBNP. The cut-off sST2 value for AHF (>64 ng/ ml) was calculated, which provides an optimal balance of sensitivity, specificity and accuracy of the prognostic model. These data support the potential value of sST2 as a biomarker of AHF in STEMI.

Background: Obesity is considered to be the most wide-spared disease all over the world [1]. Having a hormonal activity, adipose tissue takes part in coordinating of metabolic processes. Taking into consideration the excess accumulation of the adipose tissue, the proceeding of metabolic process gets abidingly broken [2]. Aims: The aim of this thesis is to analyze a hormone metabolism of the hormones of adipose tissue among the patients who has obesity. Materials and methods: 30 patients with obesity without any accompanying disease were examined. This examination was done to determine the level of adipokines (leptin, adiponectin, visfatin), insulin with index calculus of insulin resistance, blood lipids. Results: The analysis showed the fact that patients with obesity have a higher level of insulin, leptin in comparison to the control group. However, the level of adiponectin among people from the control group increased the same level of patients with obesity. The essential differences in the level of visfatin has not been discovered. Hyperinsulinemia and Dyslipidemia (increased cholesterol low density lipoprotein (TC-LDL), triglycerides (TG), reduction of cholesterol of high density lipoproteins (HDL – C)) are observed alongside the increase of leptin level among the patients with obesity. Conclusion: Multidirectional changes of hormones of adipose tissue are established among the patients with obesity without somatic pathology in comparison with the ones without obesity and overweight. The determined dynamics of adipokines contributes changes of functioning of physiological systems of out organism and demands the research of more informative and essential methods of correction.

The narrowing of the lumen of the trachea due to cicatricial stenoses of the trachea is one of the urgent problems of the modern surgery. The processes taking place in the trachea and lungs lead to a change in the state of the immune system. Assessment of the dynamics of indices of nonspecific resistance is one of the methods for assessing the severity of the course of the disease. We studied the indices of nonspecific resistance of the organism in narrowing the lumen of the trachea in an experiment in the early postoperative period. The study was carried out on the basis of the scientific department of experimental surgery with the vivarium of Irkutsk Scientific Centre of Surgery and Traumatology, on 24 white male Wistar rats with a body weight of 300–350 g. We simulated narrowing the lumen of the trachea by placing a silicone tube in the lumen of the trachea for 14 days. The parameters of phagocytosis, the state of phagocytic activity of blood neutrophils, spontaneous NBT-test, induced NBT- test were studied. The animals were withdrawn from the experiment on the 3rd, 7th and 14th day. We revealed that as a result of narrowing of the lumen of the trachea with the original procedure, the nonspecific resistance of the organism was violated with inhibition of the phagocytic activity of leukocytes. There was inhibition of phagocytic activity of leukocytes and depletion of the functional reserve of leukocytes.

Aim. To investigate on the influence of trimetazidine MR on biomarker dynamics of myocardial necrosis and heart failure in early post-surgery period in coronary heart disease (CHD) patients, undergoing extracardiac thoracal surgery.Material and methods. Totally, 72 men included, mean age 61,0 (57-66) y. o. Patients were randomized to the intervention group (n=35), receiving trimetazidine MR (Preductal MR®) 35 mg b. i.d., prescribed before operation for 2 weeks, and controls (n=37). In the studied groups, we assessed and compared perioperational troponin I dynamics, fatty acid binding protein (FABP) dynamics, and N-terminal pro-brain natriuretic peptide (NT-proBNP), measured the day before, and in 24 and 48 after surgery.Results. Baseline level for all biomarkers did not differ in groups. After the intervention, in both groups there was increase of troponin I, but not outside reference range. Troponin I >0,1 ng/mL was found in 2 patients from control group. Mean level of FABP increased after the operation in both groups. In 48 hours, in trimetazidine MR group, comparing to controls, the following were lower (p<0,05): median FABP (1,0 and 1,9 ng/mL, resp.) and part of patients with FABP >5,0 ng/mL (2,9% and 18,9%), medians of NT-proBNP, in 24 hours (184,0 and 293,3 pg/mL) and 48 hours (160,6 and 334,0 pg/mL) after surgery were also lower in trimetazidine MR group. In this group, in 48 hours after surgery NT-proBNP rarer reached the level of 300 pg/mL and higher (in 20,0% and 51,4%). The analogous result was found in subgroups of patients with baseline normal NT-proBNP. In these subgroups, the grade of NT-proBNP increase in 24 hours after surgery differed as well (by 160,3 and 242,2 pg/mL).Conclusion. The achieved results witness on the cardioprotective effect of trimetazidine MR in CHD patients under circumstances of perioperational myocardial stress, caused by an open extracardial operation.

Objective . To study the renal function in relation to fibrosis, inflammation and left ventricular ejection fraction in patients with essential hypertension (HTN) and atrial fibrillation (AF). Design and methods . The main group included 69 males with HTN and AF, the control group consisted of 17 hypertensive males without AF. The average age was 55,0 (50,0–57,0) and 52,0 (45,0–56,0) years old, respectively. We identified firstmorning urine albumin, plasma creatinine, cystatin C, high-sensitivity C-reactive protein (hsCRP), and matrix metalloproteinase-2 (MMP-2). Glomerular filtration rate (GFR) was calculated by the CKD-EPI formula based on creatinine and cystatin levels. Left ventricular ejection fraction (EF) was determined by echocardiography. All the parameters were compared in the study groups, as well as in patients with different forms of AF. We also evaluated fibrosis and inflammation severity as well as cardiac function in relation to renal function. Results. In the main group the level of cystatin C was higher and GFR lower than in the control one (1,4 (1,2–1,7) and 1,2 (1,0–1,4) mg/l, p = 0,015; 62,2 (54,9–73,2) and 73,2 (66,1–78,6) ml/min/1,73 m 2, p = 0,01). The groups differed in the incidence of GFR < 60 ml/min/1,73 m 2 (40,6 and 11,8 %, respectively; p = 0,025). Paroxysmal AF was diagnosed in 29 men (42,0 %), persistent AF — in 17 (24,6 %), and permanent AF — in 23 cases (33,4 %). Cystatin C level increased from 1,3 (1,1–1,4) mg/l in paroxysmal AF up to 1,7 (1,2–1,8) mg/l in persistent AF and up to 1,5 (1,3–1,7) mg/l in permanent AF (p = 0,006). Plasma MMP-2 level was higher in AF patients than in the control group (16,4 (13,9–19,3) and 11,3 (9,8–12,1) ng/ml, respectively; p < 0,001). It also increased from 14,6 (12,1–18,4) ng/ml in paroxysmal AF up to15,5 (12,9–16,5) ng/ml in persistent AF and to 18,0 (16,4–21,6) ng/ml in permanent AF (р = 0,009). In the main group mean EF was lower than in the control group (65,0 (60,0– 68,0) and 68,0 (66,0–71,0) %; p < 0,001). The following correlations were found in HTN patients with AF: hsCRP with cyctatin C (r = 0,34, р = 0,004) and GFR (r = –0,28, р = 0,02); EF with cyctatin C (r = –0,34, р = 0,004) and GFR (r = –0,34, р = 0,004). No significant correlations between MMP-2 and renal indicators were found. Conclusions . In HTN patients with AF compared to HTN patients with sinus rhythm, MMP-2 and cystatin C serum levels are higher while GFR is lower. Renal dysfunction and fibrosis severity increase in patients with permanent AF compared to persistent and paroxysmal forms. Deterioration of renal function at AF is associated with inflammation increase and left ventricular EF decline in the absence of MMP-2 level change.

The problem of regeneration of bone structure and joint cartilage is one of the priority programs of scientific research. Regulation of bone formation at the damage is carried out by complex set of factors. A reflection of the regeneration processes is the dynamics of blood parameters, among which are the indicators of inflammatory reaction of the organism, and condition of phagocytosis system. One way to control the severity of impaired reparative regeneration is the analysis of immunological tests of the first order. The aim of our study was to investigate nonspecific resistance of the organism for any breach of reparative regeneration of bone in the lower leg. The study was performed on rabbits "Chinchilla" which simulated the breach of the terms of reparative regeneration. We assessed leukocyte profile and indicators of phagocytosis in experimental animals. Status of the phagocytic activity of blood neutrophils was evaluated on the following parameters: phagocytic index, phagocytic number, nitroblue tetrazolium test, the concentration of circulating immune complexes. We found broken shin bone reparative regeneration of rabbit at fiftieth day of observations is accompanied by leukocytosis with increased segmented neutrophils and a decrease in lymphocytes, inhibition of phagocytosis, and violation of the elimination of circulating immune complexes.

Aim. To investigate on the influence of trimetazidine MR on biomarker dynamics of myocardial necrosis and heart failure in early post-surgery period in coronary heart disease (CHD) patients, undergoing extracardiac thoracal surgery. Material and methods. Totally, 72 men included, mean age 61,0 (57-66) y. o. Patients were randomized to the intervention group (n=35), receiving trimetazidine MR (Preductal MR®) 35 mg b. i.d., prescribed before operation for 2 weeks, and controls (n=37). In the studied groups, we assessed and compared perioperational troponin I dynamics, fatty acid binding protein (FABP) dynamics, and N-terminal pro-brain natriuretic peptide (NT-proBNP), measured the day before, and in 24 and 48 after surgery. Results. Baseline level for all biomarkers did not differ in groups. After the intervention, in both groups there was increase of troponin I, but not outside reference range. Troponin I u003e0,1 ng/mL was found in 2 patients from control group. Mean level of FABP increased after the operation in both groups. In 48 hours, in trimetazidine MR group, comparing to controls, the following were lower (p 5,0 ng/mL (2,9% and 18,9%), medians of NT-proBNP, in 24 hours (184,0 and 293,3 pg/mL) and 48 hours (160,6 and 334,0 pg/mL) after surgery were also lower in trimetazidine MR group. In this group, in 48 hours after surgery NT-proBNP rarer reached the level of 300 pg/mL and higher (in 20,0% and 51,4%). The analogous result was found in subgroups of patients with baseline normal NT-proBNP. In these subgroups, the grade of NT-proBNP increase in 24 hours after surgery differed as well (by 160,3 and 242,2 pg/mL). Conclusion. The achieved results witness on the cardioprotective effect of trimetazidine MR in CHD patients under circumstances of perioperational myocardial stress, caused by an open extracardial operation.

HGF is one of the factors taking part in regeneration and recovery of liver after injury. The article is dedicated to the study of influence of single HGF intake on the indices of non-specific immune response in rats after 70% liver resection in the early postoperative period. Research was conducted on 42 six-months white male Wistar rats of 250–300 g. It was revealed that level of segmentonuclear neutrophils and lymphocytes in the group with HGF intake stand at normal level on the 2nd day and normalizes to the 11th day that testifies to the decrease of inflammatory response. Increased level of leukocytes and monocytes is registered in the group with HGF intake. Also integrity of non-specific resistance in the early postoperative period on the 2nd day is registered. Suppression of phagocytosis indices with preservation of functional activity of phagocytes was registered to the 11th day.

This work is devoted to a comparative analysis of phagocytosis in the healing of infected skin wounds under the influence of antiseptics (chlorhexidine bigluconate and “Anavidin”). Found that in the first study day in all the experimental groups phagocytic index (PI) and indicators of oxygen-biocidity neutrophils (NBT spontaneous and induced) increased with a simultaneous decrease of circulating immune complexes (CIC). Normalization of blood neutrophil phagocytic function in rats with simulated purulent wounds in the processing of “Anavidin” was observed on the 11th day, of chlorhexidine bigluconate – on the 19th day of the study. In the control group – without therapeutic interventions – violations, typical for the development of purulent wounds, have been observed.

Antiseptic Anavidin influence on healing the infected skin lesions is studied in the article. It is determined that antiseptic application promotes the system inflammatory response restriction, nonspecific resistance safety and lack of sensibilization.

We did not observed significant differences in levels of inhibin B and follicle-stimulating hormone in serum samples of men with chronic urogenital trichomoniasis and different spermogram. It confirmed that spermatogenic testicular function in these men is preserved.

В статье представлены результаты исследования показателей сперматогенеза и состояния процессов перекисного окисления и антиоксидантной защиты у 39 мужчин с хронической монотрихомонадной инфекцией. В 66, 6 % случаев были выявлены различные отклонения в параметрах сперматогенеза. В группе мужчин с хронической монотрихомонадной инфекцией и патоспермией статистически значимо хуже была подвижность и жизнеспособность сперматозоидов в сравнении с группой мужчин с хронической монотрихомонадной инфекцией и нормоспермией. Содержание лейкоцитов в группе мужчин с хроническим УТ и патоспермиейтак же было статистически значимо больше. Корреляционный анализ выявил сложные взаимосвязи между продуктами ПОЛ, показателями сперматогенеза и системой АОЗ.