Saratov Medical Journal

Republican Arthrology Center and its contribution to the development of orthopedic rheumatology

Sergey E. Grishin, Vladimir Yu. Ulyanov, Daniil M. Puchinyan, Alexander S. Fedonnikov, Vladimir V. Ostrovsky, Igor A. Norkin

Статья научная

The article provides information on the organization and functioning achievements of the Republican Arthrology Center (RAC), which has become the first specialized clinic in the Russian Soviet Federative Socialist Republic (RSFSR) that provided arthrological assistance to the population. The result of the organizational and methodological efforts of the RAC employees was the development of a network of rheumatology rooms in almost all territories of the country, along with the organization of the orthopedic rheumatology service and its separation from the cardiovascular rheumatology service. In the RAC, scientific developments were successfully carried out on the problems of arthroplasty of large joints, surgical and conservative treatment of patients with rheumatoid arthritis, osteoarthritis of large joints, prevention of contractures of the knee joint. Saratov Research Institute of Traumatology and Orthopedics (SRITO) hip joint endoprosthesis, a collapsible endoprosthesis and other constructions that have received wide recognition were created at the RAC. In the absence of international experience in creating an orthopedic rheumatology service network, the RAC was, on one hand, a pioneering phenomenon in world health care, and on the other hand, a natural consequence of the power vertical centralization in the USSR. At the same time, it should be emphasized that the need to create the RAC in the Russian Federation was caused by the growth in morbidity of rheumatic diseases, along with population aging and the prospects of orthopedic rheumatology associated, first of all, with the active introduction of total joint replacement with artificial structures in developed countries of the world. Over three decades of its existence, the RAC has been an organizational, methodological, medical, scientific and consulting center providing an orthopedic care to patients with diseases and injuries of large joints throughout the Russian Federation.

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Impact of bone marrow allotransplantation on functional state of mast cells in lymph nodes

Vitaly O. Romanov, Olga V. Vorobyova, Lyubov P. Romanova

Статья научная

Objective: to analyze the functional state of mast cells (MC) after bone marrow allotransplantation at the early stages of the experiment. Materials and Methods. The experiments were carried out on 40 outbred male mice, which were divided into 3 groups: Group 1 with intact animals (n=10); Group 2 with control animals injected with 0.85% sodium chloride solution (n=10); Group 3 with experimental animals (n=30) injected into their tail vein with a cell suspension from another mouse under ether anesthesia. The state of mast cells was evaluated by the method of staining with polychrome toluidine blue sensu P.G. Unna. Results. Forty minutes after the introduction of foreign bone marrow in the medulla, metachromatic MC were found near the vessels, and their proportion (60%) prevailed over orthochromatic MC (40%). MC were most often located in groups, especially near the vessels, in contact with each other. The morphometric parameters of MC were changing (diameter, 8.00-17.00 μm 6.00-12.00 μm vs in intact MC). Two hours after the experiment, in accordance with the degree of heparin sulfation, metachromatic mast cells were predominantly detected (92%), and extensively degranulated MC predominated (61%), p<0.05. The size of MC was changing (diameter: 3.00-9.00 μm; distance between cells: 29.00-53.00 μm). One-way analysis of variance established that there was a significant effect of the experiment duration on the change in the proportion of MC with metachromatic staining. Conclusion. An introduction of bone marrow transplant significantly changes the functional profile of mast cells.

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Features of intercellular interaction of platelets and neutrophils expressing adhesion molecules in psoriasis

Nikolay V. Sherstennikov, Sergey L. Kashutin, Alexandra K. Sherstennikova, Oleg V. Kalmin, Valentin I. Nikolaev

Статья научная

Objective: to determine the features of intercellular interaction of platelets with neutrophils expressing adhesion molecules in psoriasis patients. Material and Methods. The study included 82 patients 20-60 years of age with a plaque psoriasis or pustular psoriasis. As a control group, 50 virtually healthy individuals 20-60 years old were examined. The study of the adhesion molecules spectrum on neutrophils was carried out on a Beckman Coulter FC-500 flow cytometer (USA) using monoclonal antibodies. The platelet-neutrophil aggregates were determined sensu the method by Yu.A. Vitkovsky et al. (2006). Results. In patients with psoriasis, compared with the control group, few intercellular contacts of neutrophils with platelets were revealed. Low values of platelet-neutrophil aggregates with 3, 4, and 5 lobes in the nucleus were observed. The formation of aggregates statistically significantly correlated with the expression of LFA-1 and PECAM-1 adhesion molecules by mature neutrophils. Conclusion. Low rates of intercellular interaction of platelets with three-, four-, and five-lobed neutrophils in psoriasis were indicative of their augmented migration from the peripheral blood to the epidermis. The adhesion molecules LFA-1 and PECAM-1 play a key role in the migration of platelet-neutrophil aggregates.

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Effect of liraglutide dose on efficacy of correcting microcirculatory disorders in absolute insulin deficiency of albino rats

Daria D. Lagutina, Tatyana V. Stepanova, Angelina A. Savkina, Alexey N. Ivanov

Статья научная

The objective was to study the dose-dependent effects of glucagon-like peptide-1 receptor agonist, liraglutide, on microcirculation in white rats under the alloxan-induced insulin deficiency. Materials and Methods. Our study was carried out on 70 white rats, divided into four groups: 20 intact control animals; 20 animals of the comparison group with alloxan-induced diabetes; 10 animals with insulin deficiency, injected with liraglutide at a dose of 0.2 mg/kg per day (treatment group No. 1); and 20 animals with insulin deficiency treated with liraglutide at a dose of 0.4 mg/kg per day (treatment group No. 2). Diabetic status, skin perfusion of the posterior limb and mechanisms of blood flow modulation were assessed in all groups of animals. Results. It was established that administering liraglutide at a dose of 0.4 mg/kg per day allowed achieving complete normalization of carbohydrate metabolism in rats with alloxan-induced insulin deficiency, thereby more effectively improving the state of microcirculation, compared with a dose of 0.2 mg/kg per day. Conclusion. The efficacy of correcting the microcirculatory disorders with liraglutide correlates with correcting the carbohydrate metabolism in rats with insulin deficiency and depends on liraglutide dose. The dose-dependent effect is achieved by the endothelial mechanism of flow modulation in microcirculation. However, the restoration of the vascular tone neurogenic component is independent of liraglutide dose.

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Comparative efficiency of various molecular genetic methods in diagnosing tuberculosis

Tatyana Yu. Salina, Tatyana I. Morozova

Статья научная

Objective – to compare the efficacy of various molecular genetic methods for diagnosing tuberculosis and determining drug susceptibility to rifampicin (RIF). Materials and Methods. We conducted a retrospective study of the sputum analysis results on 1,992 patients with pulmonary tuberculosis treated at Saratov Oblast Clinical Tuberculosis (TB) Dispensary from 2014 through 2018. The following methods were used: real-time polymerase chain reaction (PCR), biological microarrays, automated Xpert® MTB/RIF technology. Statistical processing of the research results was carried out using the Bayes formula based on contingency tables (four-field table) and the χ2 test. When evaluating the significance of differences between relative values, we employed the critical significance level of 0.05. Results. In terms of etiological diagnosis of TB, higher diagnostic sensitivities of the real-time PCR and biological microarray methods (73.9% and 70.3%, correspondingly) were established, as compared with the Xpert® MTB/RIF method (34.2%) (p<0.001). The sensitivity of all methods depended on the massiveness of bacterial excretion and clinical form of TB. Conclusions: The Xpert MTB/RIF method exhibited lower diagnostic sensitivity in verifying the diagnosis of TB, whereas its operational characteristics in terms of determining RIF-resistance were sufficiently high (sensitivity at 89.7%, specificity at 89.1%, and efficacy at 89.4%), which was comparable with the characteristics of biological microarray method (93.9%, 71.8%, 82.9%; p=0.127, p<0.001, p=0.139, respectively).

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Functional prognosis of acute ischemic stroke patients from their neuropsychological features

Lydia A. Repina, Tatiana V. Romanova, Irina E. Poverennova, Natalya P. Persteneva

Статья научная

The objective was to evaluate the relationship between the patient neuropsychological condition and recovery of his/her motor activity disorder due to acute cerebrovascular accident. Materials and Methods. The study involved 103 patients with ischemic stroke in the pools of middle and anterior cerebral arteries. We carried out clinical and neurological assessments of the patient condition, and conducted neuropsychological testing via Beck Hopelessness Scale (BHS), Montreal Cognitive Assessment (MоCA), SF-36, and Visual Analog Scale (VAS). The examination was performed on three occasions: during the acute phase of cerebral circulatory disorders, after two weeks and within the range of 24-36 months. After the long-term follow-up, all patients were distributed among two groups: with a favorable outcome and with unfavorable outcome. We attempted to identify the most typical values of above-mentioned scales for each group. Results. The general physical health (GPhH) indicators based on the results of SF-36 (p=0.007), BHS (p=0.003 and 0.002), and VAS (p=0.025), collected after acute ischemic stroke, were prognostically significant. In both groups, the most important indicators for the stroke prognosis were MоCA (p=0.038), BHS (p=0.009) and SF-36 (GPH) (p=0.002), regardless of the stroke phase. Conclusion. The connection between the patient neuropsychological condition and restoring the motor functions after the stroke was revealed. The investigated questionnaires can be included in the multivariate forecast model of the stroke prognosis among other criteria for the outcome of this disease.

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