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Background. Oxidative stress plays an important role in the development of peritonitis, which leads to a decrease in antioxidant level and an increase in oxidant production. Studying ATPase activity and lipid peroxidation when using new methods of treating experimental peritonitis is of interest for clinical practice.The aim. To study the dynamics of ATPase activity and lipid peroxidation indicators in liver tissue in experimental peritonitis when using Serogard.Methods. The study was conducted on male Wistar rats aged 6 months. All animals were subjected to experimental peritonitis using the method we developed. Animals in the control group (n = 20) were intraperitoneally injected with 3 ml of physiological solution one day after modeling peritonitis; animals in the experimental group (n = 19) were injected Serogard® (AO Pharmasintez, Russia). We determined the initial values of the indicators in healthy rats (n = 7). In animal liver tissue, total and mitochondrial ATPase activity was studied, as well as the content of malondialdehyde (MDA) and diene conjugates (DC).Results. It was found that the total and mitochondrial activity of ATPases was suppressed by the day 3 of experimental peritonitis. During 14 days of the experiment, ATPase activity did not reach normal levels in any of the groups. However, animals in the experimental group had dynamics of a more steady, significant increase in the total ATPase and the mitochondrial ATPase (ATP synthase) activity with a significantly higher level than in the control group. MDA and DC in the experimental group increased by days 7–14, which indicated the activity of free radical processes and was also an indicator of the dynamics of restoration of metabolic and energy processes.Conclusion. Using Serogard in experimental peritonitis contributed to a more effective restoration of total ATPase activity and mitochondrial ATPase (ATP synthase) and on days 7–14 of the study led to an increase in the level of free radical processes activity that accompany and indicate the process of aerobic energy restoration.

In order to find out the mechanisms of pathogenesis of degenerative-dystrophic diseases of the spine, it is of particular interest to search for body parameters which are directly or indirectly interrelated with the key factors of peripheral conversion of nidus iodothyronines and constitute a system of network interactions, affecting metabolic indicators at the local and systemic level.The aim. To search for correlations of local key factors of peripheral conversion of Ligamentum flavum iodothyronines with indicators of biochemical, hematological and hormonal blood profiles of patients with stenosing processes of the spinal canal and dural sac in the lumbar spine.Materials and methods. 33 patients (15 males, 18 females) with stenosing processes of the spinal canal and dural sac in the lumbar spine were examined (mean age – 45.73 ± 1.95 years). The expression of deiodinase genes and other candidate genes was determined in Ligamentum flavum biopsies collected during surgical treatment. Biochemical, hematological and hormonal parameters were determined in peripheral blood. The resulting data array was processed in order to find correlations between the parameters of systemic and local metabolism.Results. The relationships of deiodinases with the expression of GDF5, MMP1, MMP3 and TIMP1 in Ligamentum flavum (p < 0.05) were found. Of the hormonal profile of the blood serum, the most significant indicators were thyreotropin, free triiodothyronine and thyroperoxidase antibodies. In the biochemical profile, levels of direct bilirubin, total cholesterol, HDL and LDL cholesterol and triglycerides changed along with the expression of deiodinases. Correlative relationships with the expression of deiodinases were found for the following hematological analytes of whole peripheral blood: hemoglobin, mean corpuscular hemoglobin concentration, numbers of granulocytes, lymphocytes, eosinophils, monocytes, band neutrophils, red cell distribution width and platelet crit. The data obtained indicate the involvement of peripheral conversion factors in the pathogenetic process and provide information to form a new view on the pathogenesis of degenerative-dystrophic processes in the Ligamentum flavum of patients with stenosing processes of the spinal canal and the dural sac in the lumbar spine.

New data have been obtained for assessing the expression of genes of metalloproteinases and their tissue inhibitors (MMP-1, MMP-2, MMP-3, MMP-8, MMP-9, TIMP-1 and TIMP-2) in the Ligamentum flavum in patients with lumbar stenosis of spinal canal and dural sac. The features of the metabolism of the extracellular matrix (ECM) were revealed, the data obtained were compared with those for previously studied candidate genes. The search for relationships with the features of the ECM metabolic characteristics was carried out.The aim. To study the expression of genes of metalloproteinases and their tissue inhibitors in intraoperative biopsies of the Ligamentum flavum of patients with lumbar stenosis of the spinal canal and dural sac.Materials and methods. A group of 33 people (17 women, 16 men) with lumbar stenosis of the spinal canal and dural sac was studied; the average age is 45.73 ± 1.95 years. RNA was isolated from intraoperative biopsies of the Ligamentum flavum, reverse transcription was performed, and PCR using specific primers was performed.Results. In Ligamentum flavum of patients with stenosing processes of the spinal canal and dural sac, an increased activity of MMP-1 and insufficient response of TIMP-1 and TIMP-2 were found; the expression of MMP-1 increased synchronously with Dio2, and both genes decreased their activity with increasing age of the patient. In patients with Ligamentum flavum ossification, the MMR-8 gene was more actively expressed, and the synthesis of the mRNA of the MMR-9 gene decreased compared to the subgroup without ossification.

Parathyroid hormone receptors PTH1R and PTH2R are poorly studied in the pathology of the vertebral column and may be involved in both ectopic ossification of the vertebral ligaments and fibrous growth of the extracellular matrix, as well as in other unknown processes occurring in the pathological focus. Aim. To study the expression of genes encoding parathyroid hormone receptors in intraoperative Ligamentum flavum samples of patients with stenosis of the spinal canal and the lumbar dural sac of the spine and to assess the correlation with the expression of other genes active in connective tissue in conditions of developing pathology.Materials and methods. Studies of the Ligamentum flavum were performed in 33 patients (17 women, 16 men) with stenotic processes of the spinal canal and dural sac of the lumbar spine. RNA was isolated from the biopsies using Qiagen reagents (Germany). Then reverse transcription was performed. cDNA was used for setting up a polymerase chain reaction (Promega Reagents, USA) using a CFX96 thermal cycler (Biorad, USA) with specially selected specific primers.Results. The expression of genes encoding parathyroid hormone receptors PTH1R and PTH2R was detected and evaluated for the first time in intraoperative Ligamentum flavum samples of patients with spinal canal and dural sac stenosis, and their relationship with the activity of genes encoding estradiol receptors (ESR1 and ESR2) and FGFR3 was revealed. For the first time, common features of PTH1R and PTH2R gene expression, as well as their differences, were revealed. It is proved that the intensity of expression of parathyroid hormone receptors in intraoperative Ligamentum flavum biopsies does not depend on age, gender, or the presence of bone and cartilage nodes according to MRI results. The interdependence of differential changes in the expression of genes of the receptor apparatus involved in the metabolism of Ligamentum flavum tissues was revealed.

Background. Ligamentum flavum is involved in the development of stenosis of the spinal canal and dural sac, but the mechanisms underlying degenerative-dystrophic changes have not yet been sufficiently studied. Aim. To study the expression of candidate genes potentially involved in connective tissue metabolism in intraoperative samples of Ligamentum flavum of patients with stenosis processes of spinal canal and duralsac on the lumbar spine.Materials and methods. During the surgical treatment, Ligamentum flavum biopsies were collected from 33 people with stenosis processes of spinal canal and dural sac on the lumbar spine (16 men, 17 women). RNA was isolated, then reverse transcription was performed. After that, real time PCR was performed (CFX96, Biorad) with the specific primers (RealTimePrimers.com).Results. The characteristics of the expression of candidate genes that are active in the Ligamentum flavum of the examined patient population are given: NAT1 and NAT2 acetyltransferase genes; genes that determine the intensity of local metabolism (Dio1, Dio2 and Dio3); estradiol receptor genes ESR1 and ESR2; genes encoding receptors for growth factors and parathyroid hormone. All Ligamentum flavum samples showed activity of the NAT, ESR 2, FGFR1, FGFR3, NA20, PTH1R, and PTH2R genes. In the vast majority of samples (93.9–97.0 %), the following genes were active: PDGFA, ESR1, CALCR, and PDGFB. In 21.2–39.4 % of samples, “silence” of the Dio1, Dio2, Dio3, NAT2 and GDF5 genes was detected, and only 39.4 % of samples revealed NAT1 transcripts. The highest heterogeneity of transcript content was observed for Dio1, NAT2, and Dio2. The most stable expression in Ligamentum flavum tissue and a narrow range of fluctuations were characterized by genes with a high level of activity AANAT, ESR2, NAA20 and genes with an average level of activity FGFR1, FGFR3, PTH1R and PTH2R.Conclusions. Ligamentum flavum is a promising little-studied substrate for molecular genetic research. The revealed features of gene expression provide new information about pathogenesis, and the new fundamental knowledge obtained can provide a basis for developing methods for preventing the development of epidural fibrosis.

Background. ERK1 and ERK2 (extracellular signal-regulated kinase) are related protein serine / threonine kinases that are involved in the regulation of the cell cycle, cell migration and survival, differentiation, metabolism, and proliferation. Evaluation of this cascade is promising to determine the possibility of influencing pathological conditions through the regulation of ERK1/2.Aim of the study. To assess the involvement of the ERK MAPK cascade in the development of adhesions in the abdominal cavity.Methods. The experiments were carried out on male Wistar rats. The adhesion process in the abdominal cavity was simulated (n = 40). The research time is from 2 hours to 30 days. Tissue samples from 5 intact animals were examined as a control. Histological sections were prepared and stained histochemically for ERK1. The expression of ERK1 and ERK2 was assessed by PCR.Results. Using the PCR method, the involvement of both the ERK1 and ERK2 cascades in the process was established, and, judging by the change in gene expression, the latter is more actively involved in the process. Histochemical study confirmed the role of ERK cascades in the management of repair in serous membrane injury. Histochemically revealed an increase in ERK1 expression with two peaks of activity – at 1 and 30 days.Conclusion. Our data establish multichannel control of the reparative process in the area of damage to the serous membrane with the involvement of both the p38 and ERK MAPK cascades, which is important to consider when developing methods of influencing the wound healing process in the abdominal cavity.

Background. Mechanisms are known that allow partial local regulation of the thyroid status of tissues using peripheral conversion of iodothyronines, which determines the local level of metabolic activity. The molecular mechanisms of degenerative-dystrophic changes in the ligamentum flavum are not well understood; only a few studies on the expression of genes in this substrate have been published.The aim of the study was to identify key factors in the peripheral conversion of iodothyronines in ligamentum flavum in patients with stenosis of spinal canal and dural sac in the lumbar spine and to evaluate the features of the expression of deiodinase genes depending on the severity of ossification processes of ligamentum flavum.Methods. A group of patients with stenotic processes of the spinal canal was examined: 31 people (15 men, 16 women). The average age was45.73 ± 1.95years. In intraoperatively collected samples of ligamentum flavum, the expression ofdeiodinase genes (real time PCR) was studied and the severity of ossification processes was evaluated using a histopathological study.Results. The key factors of peripheral conversion of iodothyronines in intraoperative bioptates of the ligamentum flavum of patients (n = 31) with stenosis of the spinal canal at the lumbar level were revealed. Information was obtained on the local level of metabolic activity in the focus of pathology. The intensity and variability of deiodinase gene expression in ligamentum flavum samples were evaluated. The distribution of deiodinase gene expression patterns in groups formed on the basis of presence/absence of ossification of ligamentum flavum was found. Various variants of peripheral conversion of iodothyronines in biopsy samples of the yellow ligament of the operated patients were determined and the frequency of their occurrence was estimated.Conclusion. The key factors ofperipheral conversion of iodothyronines in intraoperative biopsy samples of the ligamentum flavum of patients with degenerative diseases of the spine were revealed for the first time. The reasons for the differences in tissue metabolism of iodothyronines and the place in the pathogenesis of stenotic processes are yet to be found.

Adhesive process in the abdominal cavity is one of the most frequent complications of intra-abdominal surgery.The aim of the study was to evaluate the activation of the JNK MAPK cascade during the experimental adhesion process.Materials and methods. Experimental studies were performed on 40 male Wistar rats (9 months old). We modeled the adhesive process in the abdominal cavity. At the time from 2 hours (2, 6, 12 hours) to 30 days (1, 3, 7, 14, 30 days), a JNK MAPK cascade was evaluated in the zone of damage to the serosa using immunohistochemical methods (painting on JNK1 Phospho (pT183) / JNK2 Phospho (pT183) / JNK3 Phospho (pT221)) and real-time PCR (the MAP Kinase Signaling Pathway RT2 - Profiler ™ PCR Array (Qiagen) kit). Results. We have found that the expression of the phosphorylated part of the JNK MAPK cascades has an undulating dynamics with two peaks on the 3rd and 14th day. It has been determined that all three JNK cascades are involved in the process, and all JNK cascades are synchronously activated on the 3rd day (JNK1 increases 12-fold in comparison with the group of intact animals, JNK2 is 8-fold, JNK3 is 10-fold). On the 14th day, the activity of the JNK3 cascade is the most intensively increased – 30 times (for JNK1 – about 6 times, JNK2 – 12 times). Conclusion. Significant activation of MARK cascades has been established on the 14th day after traumatic injury, which indicates the need for long-term prevention of posttraumatic changes, in particular, the formation of adhesions.

Background. Postoperative adhesions are a serious problem in surgery. However, at the present time molecular mechanisms of the adhesion process are insufficiently studied. Aim. To study the dynamics of expression of genes encoding the synthesis of collagen in case of damage to the serosa on the example of the peritoneum in conditions of aseptic inflammation. Materials and methods. Aseptic inflammatory process in the abdominal cavity was modeled (Wistar rats, n = 40). A micro- and macroscopic picture of the damage area was studied. Immunofluorescent staining for Type I collagen (Col 1A1) was performed. The expression of genes encoding collagen of different types was evaluated using the RT2-Profiler PCR kit Array Rat Wound Healing. Results. It has been established that the adhesion process with peritoneal damage in aseptic conditions reaches its maximum by the 30th day of observation. The same period coincides with the maximum of collagen synthesis in fibroblasts in the repair area, revealed by immunofluorescence study. The interrelation of synthesis of type I and III collagens went as expected - the onset of expression of type III collagen (from day 3) is ahead of the expression of collagen type I (from day 7). Peak gene expression of collagens type I, Alpha-1 and -2; type III Alpha-1, type IV Alpha-1 and -3, type V Alpha-1, -2 and -3; type XIV Alpha-1 (Col14a1) falls on the 14th day. For the first time, active involvement of type V alpha-3 collagen in the adhesion process was noted - we detected both early (from day 1) and maximum intensive (up to 166.96 times increase in comparison with intact animals). Conclusion. Perhaps, the hyperexpression of collagen V alpha-3 that we revealed is an important link in the pathogenesis of adhesion in the abdominal cavity.

Adhesive process in the abdominal cavity was simulated in Wistar rats. The animals were divided into two groups: the main one - simulation of adhesive process in the abdominal cavity and introduction of 3 ml of saline into the abdominal cavity; and the controls - simulation of adhesive process in the abdominal cavity and introduction of 3 ml of new antiadhesive preparation. We evaluated biochemical parameters at eight time points during the period from 2 hours to 28 days. The introduced drug for adhesion prevention did not affect the protein-synthetic function of the liver: the blood level of whole protein was the same in both groups and remained within the normal range throughout the follow-up period. The blood level of creatinine, which is the end product of protein metabolism reflecting the renal excretory function, was within normal values in both groups throughout the observation period. Significant differences between the groups were noted only on the 28th day of the experiment: in the main group creatinine level was higher as compared to the control group (p = 0.014), but remained within the normal range. The same pattern was observed when evaluating the blood urea level, which reflects the renal excretory function - the blood urea level remained normal in both groups throughout the experiment. Hence, the new antiadhesive drug does not produce toxic effect on liver and kidneys in a single intraperitoneal introduction in experiment. Biochemical indices are the same as in single intraperitoneal infusion of saline.

Aim. To evaluate the safety and efficacy of the “WATCHMAN” occluder (OW) in atrial fibrillation patients (AF) during hospital period and in 12 months after the procedure.Material and methods. Frоm 2013 to 2015 years, in the N. A. Semashko Central clinical hospital № 2 of “RZD”, 15 OW were implanted to patients with persistent AF of non-rheumatic origin, admitted for electro cardioversion, or electrophysiological study and radiofrequency ablation, pacemaker implantation. Indications for endovascular intervention were the threat of repeated embolism, high bleeding risk, severe comorbidities, and inefficacy of antithrombotic therapy. From the study were excluded those with stenosis of the left atrioventricular space and thrombi in the left atrium auricle (LAA). During pre-surgery period, all patients underwent standard transthoracal and transesophageal echocardiography for assessment of the LAA anatomy, its size in four points of view and its position to the left upper pulmonary vein. For stroke risk assessment and of thromboemolic complications the score CHA2 DS2 was used and its new edition CHA2 DS2 -VASc. Before the discharge from clinic, all patients underwent transesophageal echocardiography, repeated in 6 weeks, 6 and 12 months.Results. Mean age of patients was 52 year old. All patients had successful OW implanting. Interventions were done without general anesthesia, under local anesthesia. Mean duration of surgery was 42±11,3 min. To every patient one device was utilized. There were no replacements of OW for wrong sizing or other reasons. In 5 patients (anatomy as “chicken wing”) under angles 90-135º there was protrusion of lower border of OW found by 1/3 of the length. In patients with LAA OW sizes 33 and 27, there was residual flow registered under the lower border, of5 mmand2 mmdiameter, respectively. There were no complications during operation and nearest post-operation period. In 12 months after the study there was not dislocation, embolization or position changes among the devices. The residual flow diameter in33 mmimplant patient decreased in 6 months from 5 to2 mm, in the other — remained2 mm. No patients had brain circulation disorders and other embolies.Conclusion. The method of OW implanting into LA of non-rheumatic origin is effective method of embolic complications prevention, not followed by bleedings and making to prognosis improvement of this kind of patients, as to quit entire life anticoagulation

Life quality (LQ) is an integrated parameter of the health, applied for integral characterization of population health, and as the parameter of healthcare interventions effectiveness.Aim. To assess LQ in Russian population at the age 25-64 y. o. in general and in various socio-economical groups using EQ-5D, by the results of ESSE-RF (2012-2013) study.Material and methods. LQ was assessed on representative selections of inhabitants of 13 Russian Federation regions, aged 25-64 (males 8327, females 13497) with response 80%. LQ was assessed via international questionnaire EUROQOL — EQ-5D: 1) no decline; 2) mild decline; 3) significant decline; scoring also performed with visualanalogue scale (VAS). Integral LQ by EUROQOL performed with Shaw JW et al. method (ranging from 0,0 (death) to 1,0 (perfect health)).Result. EQ-5D index of Russian population was 0,87 with no gender difference. By the increase of the age LQ declines. Educational gradient of LQ was significant only in VAS (p

Aim. To assess rate of familiarity and specifics of treatment with statins among the citizens of economically active age with various cardiovascular risk by the data from epidemiological study ESSE-RF (Epidemiology of Cardiovascular Diseases in Different Russian Federation Regions). Material and methods. In the work the data from ESSE-RF study was used, of representative selection of non-organized male and female inhabitants aged 25-64 y.o. from 13 regions, investigated during 2012-2014. Responded ~80%. The study included questionning by standard scale that included data on the anamnesis, etc. Lipid profile, including total cholesterol (TC), cholesterol of lipoproteids low and high density were measured at SSRCPM and RSPCC.Results. Analysis of the whole selection showed that 20% of men and 32% of women knew their TC, and 13,6% and 18,2% were even familiar having increased level of TC. Part of those with high and very high risk was 31,3%, incl. men — 42,2%, women — 30,9%. Statins took ~7,0% of patients from this risk category. Effectiveness of treatment (target levels reached of low density cholesterol) in these groups of men and women was 14,4% and 4,8%, respectively.Conclusion. The data obtained in populational study points on insufficient knowledge and low rate of statin treatment of the persons with high and very high cardiovascular risk in RF, which confirms the anxiety provoking data of registries and other studies. The data dictates necessity of development and implementation of specific educational programs for citizens, of physician improvement and availability of cheap but effective lipid-lowering medications.

The research was carried out on 9 rabbits (males) of Chinchilla breed with modeling of standard perforating fracture of femoral bone. We performed intraosseous introduction of nanocomposite elemental selenium and heteropolysaccharide arabinogalactan 50 mg Se/kg to individuals of experimental group (n = 3) and NaCl 0,9 % to individuals of control group (n = 6). It was established that local intraosseous introduction of the nanocomposite with perforated fracture model did not affect basal metabolic indicators (body temperature, oxygen consumption, carbon dioxide production), but boosted the metabolic processes in the area of the surgical wound from the 9th to 21st days. It proves the bioavailability of the drug and the possibility of creating a local depot of selenium using a nanocomposite.

Managing bone tissue regeneration is a key problem in traumatology and orthopedics. The researches proved that thyroid hormones affect hemostasis and reparative regeneration of bone tissue favorably and promote osteogenesis and bone consolidation. The aim of this research is to study the influence of disturbed reparative regeneration on the concentration of thyroid hormones in blood in the dynamics. Experimental research on rabbits (n = 12) with modelling of disturbed reparative regeneration revealed disorder in thyroid hormones synthesis and different directions of T3 and unbound T3 production on the 35th day when the maximum decrease of T3 (2 times) and unbound T3 (1.5 times) compared to normal values was registered. The analysis of production of T4 and unbound T4 revealed suppression of the values from the 1st to 50th day and gradual increase in unbound T4 from the 50th day. The most significant manifestation of thyroid gland reaction on the disturbed reparative regeneration of shin bones was the decrease in T3 and peripheral conversion of thyroid hormones up to 50th day with formation of false joint in these terms.

Aim. To study the prevalence of ischemic heart disease as one of the most common cardiovascular disorders, together with arterial hypertension (AH), diabetes mellitus (DM) and liver diseases (LD) in adult (25-64 y.o.) population of selected RF regions, the variance of those with gender and age, and association of cardiovascular risk factors (FR).Material and methods. Into analysis we included the results of representative selections studies from 13 RF regions, studied according to the program of multicenter study ESSE-RF during the years 2012­2014; totally 21923 patients studied. Investigation included standard questioning, including anamnesis. For statistics we used applied software SAS.Results. In men the prevalence of IHD is associated with the growth of comorbidity from 0 in the age group 25-34 y. to 77% in the age 55-64 y., almost duplicating every decade. For women there is analogic tendency, less prominent. In men there are significant associations only with AH, which increases the risk of IHD 2,5 times, though in women together with AH the associations are significant for LD. Comorbidities with DM do not influence the prevalence of IHD in men and women. At the same time, any association with two diseases increases the risk of IHD >304 times. The most negative is the association of all three diseases, with which IHD is 8,7 times more prevalent, than in their absence. Using multidimensional logistic regression after correction for the age and comorbidity in the patients with IHD of both genders, there are associations revealed of high density cholesterol lipoproteids (HDL) in blood and abdominal obesity. In men there are also positive associations with smoking and negative — with increased cholesterol.Conclusion. Comorbidities of IHD with AH, DM and LD in adult population are common, are associated with the general FR, are increasing with the age. Taking modern tendencies of population ageing, it is plausible to expect an increase of the prevalence of comorbidities, that requires a necessity of the healthcare services to these changes.

Aim. To study social and economic gradients — educational and occupational statuses, wealth level, behavioral risk factors (FR) in Russian population by the ESSE-RF data.Material and methods. The data for the analysis consisted of representative selections of 13 regions of RF (n=22906) participants of the study, incl. men (n=8353) and women (n=13553) of 25-64 y.o., with response 80%. We calculated the odds ratios for the presence of behavioral FR: smoking, excessive alcohol consumption, insufficient physical activity (IPA), nonrational food consumption, anxiety and depressive disorders, — in persons from different social and economic groups by education level, type of inhabitation, professional status, wealth level.Results. Higher education was associated with better FR profile, except IPA (negative association) and alcohol consumption (absence of association). "White in general had less FR probability than Blue, excl. IPA and psychoemotional deviations (in men). As for the wealth association with the FR there is backward gradient, i.e. lesser the income, higher the risk of FR presence, excl. IPA and excessive alcohol intake in women. For example, in very wealthy men the odds ratio for depressive states was 3,09 [95% CI 2,08-4,57] comparing to the persons with low income. The type of territory of inhabitance was associated with less behavioral FR in Russian population, as significant associations are found only for depression and excessive salt consumption in both genders and IPA in men. Conclusion. The significant social and economic gradients of behavioral FR prevalence are found, the direction of those is not necessary the same as in European countries. The analysis of association with social and economic parameters would help to develop the directed preventive interventions.

A characteristic feature of stenosis process of the spinal canal is the destruction of elastin and fibrosis of the extracellular matrix, as well as hypertrophy and ossification of the ligamentum flavum. Proven participation in these processes of genes CTGF, PDGF-BB, TGF-ß, Il-6, TNF-α, MMPs, TIMPs, etc. Potent inducer of extracellular deposition of collagen in hypertrophies ligamentum flavum is TGF-ß; GDF-5 has osteogenic effect, increases the activity of alkaline phosphatase and the expression of osteocalcin, induces mineralization; FGFR3 gene expression contributes to the closure of synchondroses and merging of centers of ossification, contributing to excess synthesis of bone tissue, etc. Local or a systemic effect on the expression of these genes may be effective to prevent progression of the disease. Predisposition to stenosis and responsiveness to therapy is genetically determined and is expressed in individual differences in metabolic status. A very important role in the pathobiochemistry of connective tissue are the processes of acetylation by regulating the expression of essential genes that affects all intracellular processes and especially in the fibrogenesis. An imbalance of acetylation may lead to excessive synthesis of collagen, accelerating the growth of connective tissue, disruption of lipid homeostasis. Therefore, it is relevant as the definition of NAT2 polymorphism and phenotypic identification of the rate of acetylation in the population, as well as finding relationships with various pathological processes. Meaningful impact on the processes of acetylation may contribute to the sanogenesis. The information presented in the review is important for the formation of a new perspective on the pathogenesis of stenosis process in the spinal canal and can contribute to the development of new approaches to treatment.

The aim of the research was to study influence of dexamethasone and adrenaline on the concentration of energy metabolism substrates in blood of Chinchilla rabbits under the conditions of multiple skeletal trauma. We performed stabilization of the bones of right forearm and left shin in 35 animals by wire external fixation device with further osteotomy of bones of corresponding segments. We observed the decrease of activity of metabolism in rabbits on the background of standard treatment. Maintenance of normal activity of metabolism by prescription of adrenaline and dexamethasone caused more intensive use of energy resources of an organism. Imitation of hyperergic reaction of stress-realizing systems in rabbits caused the increase of concentration of glucose in blood and the decrease of concentration of triglycerides. High consumption of energy substrates was provided by more expressed catabolic reaction. The result of hypercatabolism was development of hypoproteinemia, hypoalbuminemia and increase of the risk of fluid shift from bloodstream into the tissues with formation of organ insufficiency.

There were 81 patients with vertebral canal stenosis under observation. All patients underwent complex examination: study of clinical neurological status; review spondylography of lumbar part of the spine; MRI of lumbar part of the spine; multispiral CT with myelography of lumbar part of the spine; functional spondylography of lumbar part of the spine with load; the study of morphometry of vertebral canal, dural sack and vertebra body by designed method; the study of acute phase proteins in blood. Conducted complex research revealed that improved classification of stenosis of vertebral canal reflects direct dependence of severity of clinical-neurological manifestations from the degree of stenosis. It also has been marked that reduced concentration of α2-macroglobulin in blood manifests itself in negative regulation of cells of immune system. And an increase of classic rheumatoid factor (Ig M-RF), α1-antitripsin and α1-acid glycoprotein in blood serum leads to reduction of inflammatory and immune response. Revealed direct co-dependence of severity of disease and degree of stenosis gives a possibility to develop more precise program of conservative and surgical treatment.

The article is devoted, to the study of secretion of hormones of hypophysis, sexual gland and adrenals in patients with postoperative cicatricial-commissural epiduritis. Concentration of some hormones of hypophysis, sexual glands and adrenals in blood serum of 45 patients with postoperative cicatricial-commissural epiduritis before and. after standard conservative treatment was defined. Typical changes in secretion of studied hormones at postoperative cicatricial-commissural epiduritis were revealed. It was showed that standard scheme of treatment partly grades revealed endocrine disorders. Appropriateness of including research of hormonal profile for solving the problem of its possible correction in the complex of examination of patients with postoperative cicatricial-commissural epiduritis and. of calling endocrinologist for the examination of patients and further enhancement of the scheme of their treatment was proved.

The participation of Se in the structure of deiodinases during the metabolism of thyroid hormones defined the interest to the research of its possible impact to the processes of reparative regeneration of bone tissue in the experiment. The aim of the paper is to reveal the dynamics of thyroid hormone secretion at further adding of selenium under the conditions of standard fracture healing in rabbits. The most general response of the thyroid gland at the reparative regeneration of bone tissue was revealed, it is the reduction of Т, T4 and free T4 concentration during the nearest postoperative period. It is shown, that the use of the preparation of Se changes the reaction of thyroid to the dosed damage of the bone and metabolism of iodothyronines as well. The change of T3 concentration was the most evident. Rabbits having extra preparation of Se were less susceptible to fluctuations in the secretion of iodothyronines typical for the dosed damage of the bone but the syndrome of «low Т3» redoubled and peripheral conversion of thyroid hormone reduced.

In experiment reproduced model of multiple skeletal trauma (fracture of bones of right forearm and lift shin) with stabilization of fragments with external fixation devices in 35 Chinchilla rabbits. All manipulations were realized, at general anesthesia. Standard treatment included anesthesia, antibiotic prophyliaxis and. infusion therapy by common method. Decrease of metabolism activity was registered in the first group of laboratory animals at the standard treatment. That's why besided strandard treatment dexamethasone and adrenaline in average recommended doses was prescripted in the second group of rabbits in postoperative period for correction of posttraumatic hypobiosis. Laboratory control in several hours after the injection confirmed stable increase of level of corticosteroids in blood but it wasn't possible to register increase of concentration of adrenaline. Correlation analysis was realize to study the connection between the contentration of endogenous hormones in blood and. metabolism activity in rabbits in conditions of multiple skeletal trauma. At the consideration data as one array we determined high-significant (р < 0,001) direct moderate correlation between the values of rectal temperature and. the concentration of free thyroxine in blood (rs = 0,414), this connection was strong on the 3rd day after trauma (rs = 0,833; р < 0,001). Also indirect moderate correlation between values of rectal temperature and. the concentration of cortisol in blood of laboratory animals was registered (rs = 0,49; р < 0,001). The results of study of influence of adrenaline and. noradrenaline on the indices of metabolism activity weren't statistically significant. Obtained data allowed to make a conclusion about importance of endocrine activity of thyroid gland in the formation of adaptation strategy.

In an experimental model of long bone fractures studied osteoclastic activity in the fracture zone. We used histological staining methods and histochemical staining with antibodies to carbonic anhydrase type II. It is shown that the use of histochemical staining to carbonic anhydrase type II cells is promising for the evaluation of osteoclastic activity in bone tissue. Application of this technique significantly simplifies the morphological study, allows a clear differentiation of osteoclastic cells.

This article focuses on the necessity of use Intraoperative Transesophageal Echocardiography (IOTEE) in valve replacement surgery. The authors present comparative estimation of IOTEE and the method of visual surgical revision in the intraoperative detection of paravalvular leaks.