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The mechanism of the relationship between pretumor changes in the bronchial respiratory epithelium and the risk of progression of non-small cell lung cancer (NSCLC) remains unclear. It has been suggested that the relationship between reactive changes in the bronchial mucosa and NSCLC progression may be caused by the functional status of monocytic-macrophage cells as important participants in infammation, which determines both the risk of premalignant changes in the epithelium and malignant progression. The purpose of the study was to investigate the phenotypic profle of peripheral blood monocytes and macrophages induced from monocytes in vitro depending on the state of respiratory epithelium in NSCLC patients. Material and Methods. The study included 39 patients with newly diagnosed NSCLC. Based on the morphological examination of small bronchi taken at the distance of 3–5 cm from the tumor, patients were divided into the following groups depending on the type of pretumor changes: no pretumor changes (n=6), isolated basal cell hyperplasia (BCH) (n=13), combination of BCH and squamous metaplasia (SM) (n=3), combination of unchanged epithelium and focal BCH (n=17). The phenotypic features of peripheral blood monocytes and in vitro-induced macrophages were assessed before treatment using fow cytometry. Results. The state of the respiratory epithelium in NSCLC patients prior to the start of anticancer treatment was associated with the phenotypic features of peripheral blood monocytes, but not with the profle of macrophages induced from them. Distortion of the response of induced macrophages to the polarizing stimuli was observed in NSCLC patients: the cultured cells responded to both M1 and M2 inducers (LPS and IL-4, respectively) with a phenotype shift to M2, while the CD206 marker expression varied depending on the presence and type of pretumor changes. Conclusion. The phenotypic profle of peripheral blood monocytes was associated with the state of the respiratory epithelium in NSCLC patients before anti-tumor treatment, but not with the phenotypic features of induced macrophages.

The aim of investigation was to study experimentally the morphological features of tissue integration of two-layer titanium nickelide (TiNi) knitwear when replacing thoracoabdominal defects.Materials and methods. The experiments were carried out on 40 Wistar rats. The experimental animals were divided into two comparison groups: in Group A (n = 20) the defect was replaced using a two-layer knitted tape made of TiNi, in Group B (n = 20) a polypropylene mesh implant was used. The technique of the operation and the peculiarities of keeping the animals did not differ. Animals were taken out after 14, 30, 60 and 90 days of experiment. The macroscopic structural features at the site of implant fixation to tissues and at the sites of contact with underlying organs were studied, and the inflammatory process was assessed. The histological and electron microscopic study was carried out with an assessment of the features of tissue integration through the mesh structure of knitwear.Results. Thirty days after the surgery in four cases of Group B the appearance of the chest wall deformation at the site of implant fixation was noted, in one case the deformation site was located along the lateral edge of the abdominal wall. Among the animals of Group A no such changes were recorded. The histological and electron microscopy examination revealed that the porous structure of the TiNi wire, as well as the biomechanical and biochemical properties of the two-layer metal knitwear, ensure optimal integration of the endoprosthesis in the body tissues, forming an elastic frame close to natural. In Group B, on the contrary, the reaction of the body caused by the implanted polypropylene prosthesis was characterized by more pronounced fibrosis, and tissue integration through the mesh structure of the implant was not observed.Conclusion. Two-layer TiNi knitwear in the replacement of complex structures of the thoracoabdominal zone showed promising results, which opens up prospects for further clinical research.

Background. Breast cancer (BC) is the most common female malignancy worldwide. Partner And Localizer of BRCA2 gene (PALB2) is directly involved in DNA damage response. Germline mutation in PALB2 has been identified in breast cancer and familial pancreatic cancer cases, accounting for approximately 1–2% and 3–4%, respectively. The goal of this report was to describe new PALB2 mutation in a young Yakut breast cancer patient with family history of cancer. Material and Methods. Genomic DNA were isolated from blood samples and used to prepare libraries using a capture-based target enrichment kit, Hereditary Cancer Solution™ (SOP HiA GE NETICS , Switzerland), covering 27 genes (ATM, APC, BARD1, BRCA1, BRCA2, BRIP1, CDH1, CHEK2, EPCAM, FAM175A, MLH1, MRE11A, MSH2, MSH6, MUTYH, NBN, PALB2, PIK3CA, PMS2, PMS2CL, PTEN, RAD50, RAD51C, RAD51D, STK11, TP53 and XRCC2). Paired-end sequencing (2 × 150 bp) was conducted using NextSeq 500 system (Illumina, USA ). Results. Here we describe a case of a never-before-reported mutation in the PALB2 gene that led to the early onset breast cancer. We report the case of a 39-year-old breast cancer Yakut woman with a family history of pancreatic cancer. Bioinformatics analysis of the NGS data revealed the presence of the new PALB2 gene germinal frameshift deletion (NM_024675:exon1:c.47delA:p.K16fs). In accordance with dbPubMed ClinVar, new mutation is located in codon of the PALB2 gene, where the likely pathogenic donor splice site mutation (NM_024675.3:c.48+1delG) associated with hereditary cancer-predisposing syndrome has been earlier described. Conclusion. We found a new never-before-reported mutation in PALB2 gene, which probably associated with early onset breast cancer in Yakut indigenous women with a family history of pancreatic cancer.

Macrophages are key components of the innate immune system. The variability of the macrophage’s participation in tumor progression, determined by their functional polarization, opens up a wide prospect for modulating their functional profile, primarily in the direction of increasing antitumor activity. The purpose of the study was to provide up-to-date data on the process of macrophage polarization, mechanisms of its regulation, polarization markers and induction factors. Material and methods. A search was made for available literature sources published in Web of Science, Scopus and other databases. more than 160 sources devoted to the study of the process of macrophage polarization were found, of which 121 were included in this review. Results. This review presents data on the molecular mechanisms and gene signatures associated with M1 and M2 polarization of macrophages. We displayed information on metabolic, phenotypic characteristics and cytokine profile of M1- and M2-macrophages, as well as highlighted data on polarization factors and targets of their action. Conclusion. The information presented in the review can serve as an information base for the development of experimental and clinical approaches for editing the functional profile of macrophages in order to control their involvement in various pathological processes.

The aim of the study was to develop and apply a perioperative complex of preventive measures aimed at reducing the incidence of respiratory complications in patients with operable forms of lung cancer. Materials and methods. The study has been conducted between September 2016 and January 2018. 103 patients with operable forms of lung cancer were treated, with anatomic resection of the lungs or pneumonectomy in the conditions of the oncology department of the Tomsk Regional Oncology Center. All patients in the perioperative period used a developed set of measures aimed at preventing the development of respiratory complications. A retrospective analysis was made of the case histories of 66 patients underwent treatment in cancer department of Tomsk Regional Oncology Center between 2014 and 2016, all patients underwent surgical treatment for lung cancer using standard prevention methods. We compared the incidence and structure of respiratory complications in a group of patients using the developed complex and in the retrospective control group. Results. The analysis of groups of patients revealed statistically significant differences in the number and structure of complications. In patients who developed the prophylactic complex at the stages of treatment, respiratory complications were registered in 4 (3.9 %) cases, while in the retrospective control group, respiratory complications developed in 8 (12.1 %) patients. According to the complications structure, the results also vary, in the group with the developed complex, none of the patients registered postoperative pneumonia while in the control group pneumonia developed in 5 cases and was the cause of death in 3 patients. Conclusion. The use of the developed complex in patients with oncopulmonological profile significantly reduces the incidence of respiratory complications in the postoperative period.

The development of respiratory complications in patients after surgical treatment of lung cancer remains a serious problem, far from being resolved today. Pain remains the main factor that leads to a decrease in respiratory function in the postoperative period.The aim of this study is to evaluate the effect of intrapleural lymphotropic blockades on the incidence of respiratory complications in the postoperative period in patients undergoing surgical treatment of lung cancer.Materials and methods. 103 patients with operable forms of lung cancer, who underwent anatomical lung resection or pneumonectomy, were treated in the Oncology Department of the Tomsk Regional Oncology Center. The patients were divided in two groups. The first group included 52 patients, who were supplemented with intrapleural lymphotropic blockades. The second group consisted of 51 patients who received a standard multimodal scheme of analgesia in the postoperative period. In the postoperative period, we assessed severity of pain in patients, and the frequency and types of respiratory disorders.Results. The analysis of the results revealed a significant decrease in the intensity of pain syndrome the first 12 hours after surgery in the group of patients, who underwent lymphotropic blockade. The analysis of the frequency of respiratory disorders in the study groups also revealed significant reduction in the number of complications in patients in the group with lymphotropic blockade. Acute postoperative pain, that prevents full natural ventilation, plays one of the key roles in the pathogenesis of respiratory complications in patients after surgical treatment of lung cancer.Conclusion. The use of multimodal analgesia of intrapleural lymphotropic blockade in the complex allows to reduce the pain syndrome and provide psycho-emotional comfort of the patient in the early postoperative period, thereby reducing the risk of respiratory disorders.

The simple and effective method of the leakage test in thoracic surgery using laser photo-acoustic leak detector «LaserGasTest» was suggested and tested in experiment on mongrels. Sulfur hexafluoride used for the work of leak detector is an inert and biologically harmless gas of the 4th class of danger and its concentration in medical ventilation apparatus does not exceed 5000 mg/m3 (0.077 %). The proposed technique provides real-time high-frequency determination of location and size of leakage.

The original techniques of bronchus stump closure, modeling and disjunction of non-neoplastic tracheoesophageal fistula, replacement of postresectional defects of the trachea, pericardium, diaphragm and the thoracic wall using titanium nickelide implants have been developed and tested. It was ascertained that these methods were highly effective and simplified and standardized surgical procedures, provided anatomic and physiologic reconstruction of the injured area.

The results of treatment of 9 patients with mechanical injury of trachea and of 22 patients with cicatricial stenoses of trachea are presented, in this article. 18 patients had. staged, reconstructive and plastic operations at the cicatricial stenosis, 2 patients had. endoscopic recanalization of tracheal lumen and. 2 patients had. sleeve resection of trachea with, anastomosis. An. original medical complex including argon-plasmatic, cryosurgical and. lymphotropic technologies. In all cases we managed, to recover respiratory tract integrity and. to provide adequate breath through, natural respiratory tract.

Reconstruction of fenestrated tracheal defect using free revascularized flap combined with titanium nikelide implant has been developed. The experimental study was performed on 8 mongrels, on which defect or tracheostomy was created. The tracheal defect reconstruction was completed using free fasciocutaneous inguinal flap. Efficacy of the method was tested using clinical, radiological, macro- and microscopic examination. It is ascertained, that the technique permits to reconstruct fenestrated tracheal defect with minimal injury of donor zone, to simplify and shorten the operation.

Original surgical treatment for tracheobronchomalacia using external stabilization of movable segment with titanium nikelide implant has been developed. The experimental study was performed on 10 mongrels. Tracheomalacia was created by submucosal resection of tracheal cartilages. Efficacy of the method was tested using clinical, radiological, endoscopic and morphological examination. It is ascertained, that the technique permits to eliminate redundant mobility of tracheal segment simply and reliably.

Method of postresection pericardial defect closure using fabric implant on basis of nanostructural nikelide titanium fiber has been developed and tested on ten mongrels. Morphology of reclaim generated after pericardial reconstruction using fabric implant was studied. A new generated tissue has been shown to extend through implant and form single tissue reclaim, which keeps anatomico-physiological restoration of pericardial defect.