Bulletin of Siberian Medicine / Бюллетень сибирской медицины
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МОЛЕКУЛЯРНО-ГЕНЕТИЧЕСКИЕ ИССЛЕДОВАНИЯ КОМОРБИДНОСТИ
Get PDFThis review focuses at the problem of the genetic basis of comorbidity. We discuss the concepts and terms relating to combinations of diseases. The guidelines of the study of comorbidity using modern high throughput methods and approaches of genetics, molecular biology and bioinformatics are designated. In this review we present results of studies showing genetic specificity for the combined phenotypes dif-ferent from the isolated disease, we considergene-gene and gene-environment interactions in comorbidity. We also discuss the role of single nucleotide polymorphisms and structural genome variations in the development of comorbidity. Own results of researching shared genes of inversely comorbid diseases like as bronchial asthma and tuberculosis are presented.Обзор посвящен проблеме генетических основ коморбидности. Обозначены основные направления в исследовании коморбидности с использованием современных высокотехнологичных методов и подходов генетики, молекулярной биологии и биоинформатики. Приведены результаты исследований, показывающих генетическую специфичность в отношении комбинированных фенотипов, отличающуюся от изолированных болезней; рассматриваются вопросы межгенных и ген-средовых взаимодействий при коморбидных состояниях; обсуждается рольоднонуклеотидныхполиморфных вариантов и структурных вариаций генома с развитием коморбидных состояний. Приведены результаты собственного исследования общих генов для обратно коморбидных заболеваний, таких как бронхиальная астма и туберкуле
АССОЦИАЦИИ ПОЛИМОРФИЗМА ГЕНА ADRA2B С ФАКТОРАМИ РИСКА СЕРДЕЧНО-СОСУДИСТЫХ ЗАБОЛЕВАНИЙ В ПОПУЛЯЦИИ КОРЕННЫХ ЖИТЕЛЕЙ ГОРНОЙ ШОРИИ
Get PDFStudy objectives: examine the frequency of genotypes and alleles of I/D polymorphism of gene ADRA2B of native people living in Mountain Shoria (the Shors), as well as their association with risk factors for cardiovascular diseases.Material and methods. Overall 221 native people of Shoria were examined. The average age is51.07 ± 1.46 among males, 52.93 ± 0.96 among females (p = 0.286). Anthropometric characteristics, lipid levels of blood and I/D polymorphism of ADRA2B were studied.Results. DD genotype of the gene ADRA2B in the native population of the Shor people is associated with adiposis and high index of "waist/hip", hypertriglyceridemia. The average values of Quetelet index is higher in carriers of this genotype compared with carriers of genotype ID. Average waist indications in homozygous insertions were lower than those in homozygous deletions and heterozygotes. Patients with genotype DD have higher average levels of triglycerides, atherogenic index, cholesterol, very low density lipoproteins.Conclusion. DD allele ADRA2B genotype is responsible for adiposis and high levels of TG among native population of Shoria
ФОРМИРОВАНИЕ ПОВЕДЕНЧЕСКОЙ АКТИВНОСТИ МЫШЕЙ (CBAxC57BL6)F1 В УСЛОВИЯХ МНОГОКРАТНОГО ПЕРЕНОСА ИММУНОКОМПЕТЕНТНЫХ КЛЕТОК ОТ СИНГЕННЫХ ЖИВОТНЫХ
Get PDFThe features of forming of the orientation and exploratory behavior level (OEB) was established on sexually immature animals – mice (CBAxC57/Bl)F1, which underwent triple transplantation of splenocytes from adult syngeneic animals with a certain level of OEB during ontogenesis. Obtained data testifies an increase the part of passive animals in recipients group receiving splenocytes from low-level in behavior donors and an increase the part of animals with average level of OEB in recipients group receiving cells from donors with high OEB level and immature control group. The associations of recipients behavioral activity level with structural and functional features of donor cells was revealed: a relative increase in the OEB level under splenocytes transfer from donors with activated monocyte-macrophage link of immune system and a supression of OEB – from donors with activated T-cells.Установлены особенности формирования уровня ориентировочно-исследовательского поведения (ОИП) неполовозрелых животных – мышей (CBAxC57Bl)F1, подвергшихся в процессе онтогенеза трехкратной трансплантации спленоцитов от взрослых сингенных животных с определенным уровнем поведенческой активности. Результаты исследования свидетельствуют об увеличении доли пассивных животных в группе реципиентов, получавших спленоциты от низкоактивных доноров, и об увеличении доли мышей со средним уровнем ОИП в группах реципиентов, получавших клетки от доноров с высоким уровнем ОИП и от контрольной группы неполовозрелого возраста. Выявлены ассоциации уровня поведенческой активности реципиентов со структурно-функциональными особенностями клеток доноров: относительное повышение уровня ОИП при переносе спленоцитов от доноров с активированным моноцитарно-макрофагальным и подавление ОИП – от доноров с активированным Т-клеточным звеном иммунной системы
КЛИНИКО-ФУНКЦИОНАЛЬНЫЕ ОСОБЕННОСТИ И ХАРАКТЕРИСТИКА КОНТРОЛЯ БРОНХИАЛЬНОЙ АСТМЫ И ХРОНИЧЕСКОЙ ОБСТРУКТИВНОЙ БОЛЕЗНИ ЛЕГКИХ ПРИ ИЗБЫТОЧНОЙ МАССЕ ТЕЛА
Get PDFThe problem of overweight prevalence is becoming increasingly important not only in countries with high living standards, but also in developing countries, especially among the urban population. The social significance of obesity is determined by the risk of chronic non-communicable diseases in young patients and decreased overall survival. Given the high prevalence among the population of Tomsk Region of obesity and excessive weight seems actual to establish the extent of the actual impact of this disease on lung function, including patients with bronchial asthma and chronic obstructive pulmonary disease in Tomsk Region. The study included 9303 residents of the city ofTomsk, aged 18 to 88 that have passed examinations in Health Centers in 2010–2012. Among the methods of examination in health centers performed anthropometry and evaluation of respiratory function (spirometry). The study established a negative correlation between body mass index and respiratory function. The presence of obesity leads to a deterioration of the lung function parameters and associated with significantly reduces of asthma control and quality of life of patients with chronic obstructive pulmonary disease. High prevalence of overweight in the population of residents of Tomsk Region and the impact of this disease on the respiratory system seems actual to develop special programs for weight control in patients with bronchial asthma and chronic obstructive pulmonary disease and adjust screening preventive actions, paying more attention to the prevention of obesity among the population of the region.
СИНДРОМ ИЗБЫТОЧНОГО БАКТЕРИАЛЬНОГО РОСТА В ТОНКОЙ КИШКЕ У ПАЦИЕНТОВ С НЕДОСТАТОЧНОСТЬЮ БАУГИНИЕВОЙ ЗАСЛОНКИ И ПОСЛЕ ЕЕ ХИРУРГИЧЕСКОЙ КОРРЕКЦИИ (ПЕРВЫЕ РЕЗУЛЬТАТЫ)
Get PDFОbjective: diagnosis of the a small intestine of bacterial overgrowth syndrome (SIBO) in patients with the failure of the bauginias valve (FBV) and after its surgical correction.Material and methods. Patients of the studied groups were examined by means of direct and indirect methods of diagnostics of SIBO. Bacteriological research of an aspirate of aillium gut and other operational material was conducted. To all patients the hydrogen respiratory test was carried out and highquality reaction of urine to an indican was carried out. 50 patients are examined, from them 30 are inclu ded in the main group by which surgical correction of FBV – a bauginoplastik is made; 20 patients are included in group of control at which the illeocecal valve is well-founded. Patients of the main group were examined before operation and for the 7th and 45th days after a bauginoplastik.Results. At all patients of the main group SIBO of varying severity is defined, at 80% of patients of SIBO was localized in distal part of the small intestine. Patients with normal function of the ileocecal valve a SIBO did not suffer. At 76% of patients revealed signs of a mezadenitisof a small intestine, the fact of a bacterial translocation at SIBO is confirmed. In 7 days after surgical correction of the bauginiasvalve normalization of a peak and background excretion of hydrogen was noted at 37% of patients. For the 45th days at all patients the hydrogen digram met standard.Conclusions. The failure of the bauginiasvalveis obligatory followed by a small intestine of bacterial overgrowth syndrome, surgical correction is an effective method of correction of a SIBO at patients with FBV
ЭТИОПАТОГЕНЕЗ И АНАЛИЗ АНТИБИОТИКОТЕРАПИИ ПРИ СИНДРОМЕ ИЗБЫТОЧНОГО БАКТЕРИАЛЬНОГО РОСТА В ТОНКОЙ КИШКЕ
Get PDFArticle is attempt of the critical analysis of modern approaches to treatment of a small intestine bacterial overgrowth syndrome (SIBO). SIBO now is one of the major problems in gastroenterology. At the same time, the bacterial overgrowth is cause and consequence of many diseases of digestive system and extradigestive manifestations. Many researches testify to prevalence of SIBO in patients with digestive diseases. However, pathogenesis of a disease is studied insufficiently today. Nevertheless, the available data of scientific researches allow to belong to the offered ways of diagnostics and treatment critically.Data on physiology of microbiota of the digestive tract of the healthy person are provided in a review. Mechanisms of antimicrobic resistance of a microbiota of intestines are considered. Interrelations between an antibiotikassociated degeneration of normal flora and bacterial overgrowth are presented. The analysis of an antibiotiktherapi of SIBO indicates low efficiency and also possible ways became chronicle diseaseand frequent recurrence of an illness. The multiple-factors and complexity of pathogenesis of SIBO are leaded authors to a conclusion to use ethiopathogenesis approaches for solution of SIBO
СОВРЕМЕННЫЕ ВОПРОСЫ И ПЕРСПЕКТИВЫ ИЗУЧЕНИЯ ШИЗОФРЕНИИ С ВЕДУЩЕЙ НЕГАТИВНОЙ СИМПТОМАТИКОЙ
Get PDFBasic contemporary trends in schizophrenia studies with leading negative symptoms in the clinical picture has been presented. There were mainly overviewed the works resulted from original research as well as the papers clinical dynamics, the study of constitutional factors, adjustment as well as schizophrenia therapy with predominant negative symptoms. There was shown interdisciplinary character of the discussed problem in the plane of a biopsychosocial approach. There was demonstrated the priority of updating of clinical patterns phenomenology and schizophrenia dynamics with predominance of negative symptoms in connection with the upcoming transition to the new revision of the international classification of diseases and the need for profound studies of the influence of constitutional factors on the clinical dynamics and prognosis of the disorder in terms of patients adjustment and therapy.Представлены основные современные направления изучения шизофрении с ведущей негативной симптоматикой в клинической картине. Преимущественно рассмотрены работы, являющиеся результатами оригинальных исследований, а также проблемные публикации по вопросам клинической динамики, изучения конституциональных закономерностей, адаптации и терапии шизофрении с преобладающей негативной симптоматикой. Показан междисциплинарный характер обсуждаемой проблемы, лежащей в плоскости биопсихосоциального подхода. Продемонстрирован приоритет уточнения феноменологии клинических паттернов и динамики шизофрении с преобладанием негативной симптоматики в связи с предстоящим переходом на новый пересмотр Международной классификации болезней, а также необходимость углубленных исследований влияния конституциональных факторов на клиническую динамику и прогноз заболевания в аспекте адаптации больных и проводимой терапии
ОСОБЕННОСТИ ЛИПИДНОГО ОБМЕНА У ПАЦИЕНТОВ С САХАРНЫМ ДИАБЕТОМ 1-ГО ТИПА В ЗАВИСИМОСТИ ОТ НАЛИЧИЯ ДИАБЕТИЧЕСКИХ МИКРОАНГИОПАТИЙ И ХАРАКТЕРА ПИТАНИЯ
Get PDFWas investigated 67 children (36 boys and 31 girls) in age from 6 to 18 years old, with type 1 diabetes patients who were treated at the Children's Hospital Endocrinology number 1 inTomsk, average age of the boys at the time of the survey amounted to (13.0 ± 0.4) years, girls – (13.5 ± 0.4) years. All children diagnosed with type 1 diabetes were under subcompensation. Clinical evaluation of patients included a medical history, physical examination, evaluation of physical development. A study of lipid profile (high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL), cholesterol (TC), triglycerides (TG), atherogenic index). Screening for diabetic retinopathy was performed by examining the fundus by direct ophthalmoscopy after pupil dilation. Diagnosis of diabetic nephropathy, retinopathy performed according to the classification. Patients were divided into groups depending on the presence of complications, and the level of compensation lipid metabolism (children with satisfactory compensation of lipid metabolism (total cholesterol level less than 5.2 mmol / l), children with poor compensation lipid metabolism (total cholesterol above 5.2 mmol / l)). Nature of the subjects studied nutrition using a questionnaire drawn up on the basis of the standard dietary questionnaire program CINDI, allowing to evaluate the eating habits by examining the frequency of intake of various foods, food preferences and priorities. Products, according to the lipid-lowering diet on the recommendations of the European Society for atherosclerosis were combined and divided into groups according to frequency of use: commonly used products, and rarely use the products. Mathematical treatment of the results was performed using the software package Statistica 5.5 for Windows. In the first phase expected to total group performance statistics – the arithmetic mean value M and the error of the mean m, as well as visualization of the distribution of values was performed using frequency histograms. To select a criterion to assess the significance of paired differences check compliance form normal distribution using the criterion χ2, and also controlled the general equality of variances using the F-test Fisher. Given that these conditions are satisfied only part of the empirical distributions of features tested the hypothesis that the general average in all cases was performed using Mann–Whitney U-test for independent variables. Null hypothesis was rejected when p < 0.05.In the study of lipid metabolism in patients with type 1 diabetes, no increase in the level of cholesterol, triglycerides, HDL, LDL and VLDL – cholesterol in patients with a combination of diabetic nephropathy and retinopathy compared with patients with type 1 diabetes without diabetic microangiopathy. Investigation of the nature of power in patients with type 1 diabetes, allowed us to estimate its impact on lipid metabolism.Обследовано 67 детей (36 мальчиков и 31 девочка) в возрасте от 6 до 18 лет, больных сахарным диабетом 1-го типа (СД-1), находившихся на лечении в эндокринологическом отделении МЛПУ «Детская городская больница № 1» Томска. Средний возраст мальчиков на момент обследования составил (13,0 ± 0,4) года, девочек – (13,5 ± 0,4) года. Все дети с диагнозом СД-1 находились в стадии субкомпенсации. Клиническое обследование пациентов включало в себя сбор анамнеза, объективное обследование, оценку физического развития центильным методом. Проведено исследование липидного спектра (липопротеины высокой плотности (ЛПВП), липопротеины низкой плотности (ЛПНП), холестерол (ХС), триглицериды (ТГ), индекс атерогенности). Скрининг диабетической ретинопатии проводили с помощью исследования глазного дна методом прямой офтальмоскопии после расширения зрачка. Диагностику диабетической нефропатии осуществляли согласно классификации. Пациенты были разделены на группы в зависимости от наличия осложнений, а также по уровню компенсации липидного обмена (дети с удовлетворительной компенсацией липидного обмена (уровень общего холестерола менее 5,2 ммоль/л), дети с неудовлетворительной компенсацией липидного обмена (уровень общего холестерола более 5,2 ммоль/л)). Характер питания обследуемых изучался с помощью опросника, составленного на основе стандартной диетической анкеты программы CINDI и позволяющего оценить привычки питания путем изучения частоты приема различных продуктов, пищевых пристрастий и приоритетов. Продукты, согласно гиполипидемической диете по рекомендациям Европейского Общества по Атеросклерозу, были объединены по группам и разделены по частоте употребления. Математическую обработку полученных результатов проводили с использованием пакета программ Statistica 5.5 forWindows. На первом этапе рассчитывали групповые показатели суммарной статистики – среднюю арифметическую величину M и ошибку средней m, а также проводили визуализацию распределения значений с помощью частотных гистограмм. Для выбора критерия оценки значимости парных различий проверяли соответствие формы распределения нормальному, используя критерий χ2, а также контролировали равенство генеральных дисперсий с помощью F-критерия Фишера. Учитывая, что этим условиям удовлетворяла лишь часть эмпирических распределений признаков, проверку гипотезы о равенстве генеральных средних во всех случаях проводили с помощью U-критерия Манна–Уитни для независимых переменных. Нулевую гипотезу отвергали при p < 0,05. При исследовании липидного обмена у больных СД-1 выявлено повышения уровня ХС, ТГ, ХС-ЛПНП и ХС-ЛПОНП в группе пациентов с сочетанием диабетической нефропатии и ретинопатии по сравнению с пациентами с СД-1, не имеющими диабетических микроангиопатий. Исследование характера питания у пациентов с СД-1 позволило оценить его влияние на показатели липидного обмена
РАЗВИТИЕ ИНФОРМАЦИОННЫХ КОМПЕТЕНЦИЙ СТУДЕНТОВ ВРАЧЕБНЫХ СПЕЦИАЛЬНОСТЕЙ
Get PDFThe goal of this paper is the analysis of information communication technologies using for professional competencies development for medical students. There are described two informational learning technologies: standard and developed in Tomsk.Virtual learning environment Moodle is open source software which is developed for on-line education and installed in more than a dozen thousands educational institutions around the world including Russia. The Moodle provides students with rapid access to professional-oriented learning information via Internet any time and through any gadget. Using the Moodle a teacher can present different types of digital information, organize learning course, student’s knowledge and skills evaluation after structuring teacher’s knowledge. Rating approach is implemented in the Moodle very easy. Developed and developing resources for the Moodle are located at the server http://simcenter.ssmu.ru.Learning electronic health record (LEHR) is developing by Tomsk professional team and it is the integration of an electronic health record and a program for clinical subject. There are additional functions besides usual for paper medical record, for example: learning about specialized software, electronic reference books, and medical standard documents. Information and clinical competences are forming in LEHR at the same time what is the undoubted advantage for students. Now LEHR on pediatrics and neurology are testing before trial exploitation in the learning. Software for LEHR and information about virtual patients are located at the server http://students.umssoft.com.The analysis and our experience have shown the possibilities of effective using the information communication technologies for development of informational and professional competencies of medical students in different subjects of educational program