We examined 43 patients with breast cancer, who, as in the previous group, underwent percutaneous transhepatic cholecystostomy, however, the bile separated through the external drainage was preliminarily purified from toxic and ballast substances using the Lignov sorbent. Subsequently, the patients took it orally.
In the first group of patients, the concentration of IL-6 in the blood serum prior to the application of percutaneous transhepatic cholecystostomy was higher than normal, averaging 152.65±16.3 pg/ml. Immediately after the application of percutaneous transhepatic cholecystostomy in bile, this indicator averaged 68.58±7.24 pg / ml. At the end of the observation, the decrease in the level of IL-6 in the blood compared to the initial one was 64.4%, and in bile-54.3 (P<0.001). In the second group of patients, after the application of percutaneous transhepatic cholecystostomy, the concentration of IL-6 in the blood serum averaged 151.52±14.2 pg / ml, and in bile - 67.43±9.14 pg/ml. The initially high concentration of IL-6 in the blood and bile after bile absorption decreased by 75.7% (36.81±4.4 pg /ml) and 73.9% (17.57±2.2 pg/ml), respectively, from the initial level. The inclusion of bile absorption in the therapeutic complex significantly changed the concentration of IL-6 in blood serum (P<0.01) and bile.
The dynamics of parameters in blood serum and bile in patients of this group indicates a significant efficiency of bile absorption. Initially high indicators of endotoxicosis, such as SMP, TNF-α, IL-6 and bilirubin, were removed from the body by bile absorption, which made it possible to remove toxic substances from the body. The study of SMPs in blood serum and bile in patients of the main group revealed a more accelerated elimination of them with bile than in the control group. An increase in the concentration of SMP in bile was accompanied by a decrease in it in the blood serum.
The purpose of the study was to determine and evaluate the features of morphological changes in the liver parenchyma of 5-month-old white outbred rats under the influence of anti inflammatory drugs under conditions of polypharmacy.
The object of study for experimental studies was taken 250 white male rats weighing 200-250 g.
The scientific novelty of the research is as follows: polypharmacy of anti-inflammatory drugs negatively affects all parameters of liver structures. Under the influence of polypharmacy, there is a decrease in the absolute mass of the liver, volume and morphological parameters of the liver parenchyma. The decrease in morphometric parameters depends on the number of drugs in polypharmacy; under conditions of polypharmacy, the state of the hepatic capillaries and internal bile ducts, as well as biological membranes, was studied, as a result of which the structural structure of the liver, the development of destruction of the hepatic tissue were studied, and the morphofunctional foundations of this condition were shown.
Implementation of the research results. Based on the obtained scientific results, the morphofunctional characteristics of the liver of rats in the norm and under the influence of polypharmacy were determined:
Approved methodological recommendations: "Methodology for determining the morphometric parameters of the liver during polypharmacy of anti-inflammatory drugs" (Conclusion No. 8n-r / 265 dated 14.03.2022 of the Ministry of Health of the Republic of Uzbekistan) and "Methodology for determining the morphometric parameters of the liver during polypharmacy of anti-inflammatory drugs" (Uzbekistan, Conclusion of the Ministry of Health of the Republic of Uzbekistan No. 8 n-z 180 of 2022), electronic program No. DGU 1038 "Program for studying the comparative characteristics of morphological changes caused by polypharmacy in the liver."
The scientific results obtained in the study of morphological and functional properties and morphometric changes in the structure of the liver under the influence of polypharmacy have been introduced into the practice of the Samarkand branch of the Republican Specialized Oncological and Radiological Scientific and Practical Medical Center of the Samarkand City Medical Association (Order of the Ministry of Health of the Republic of Uzbekistan dated March 14, 2022, 8n-r / 265-No. and conclusion No. 8 n-z 180 of 2022). The implementation of the obtained research data allows developing methods for early diagnosis, treatment and prediction of organopathology by morphological parameters, improving the quality of life and reducing the number of complications.
The structure and scope of the dissertation. The structure of the dissertation consists of an introduction, three chapters, a conclusion and a list of references. The volume of the dissertation was 103 pages.
Topicality and demand of the subject of dissertation. Bronchial asthma (BA) is one of the most common and serious diseases, which in the world suffer from 3 to 12% of the child population of the globe. Proportion of adolescents with asthma, is one third of all children with this disease. High prevalence of asthma in the numbers of teenagers, characteristics of the disease, age-related aspects of the functioning of the endocrine and immune systems of teenagers that cause difficulties which arise in the course of the diagnostic process, highlight the need to find innovative approaches to diagnosis and treatment of this disease.
It is known that the key immune mechanisms in the pathogenesis of the vast majority of AD cases is real and indisputable fact. Currently, considerable interest to researchers involved in the pathogenesis of positions of allergic diseases, especially asthma, along with IL-4 and IL-13 causes a number of other (IL-6, IL-8, IL-10, IL-5, INF-a and INF-y) immunoregulatory cytokines.
Genetic predisposition plays an important role in the development of allergic diseases. Currently available data on the relationship with asthma and associated with disease symptoms polymorphism approximately 150 genes. Important role as the main contender for the predisposition to asthma gene is a gene encoding flchain of high affinity receptor IgE. Interaction elevated levels of antigen-specific IgE with FceRip plays a central role in the pathogenesis of allergic asthma. Particularly attractive candidate gene asthma is also one of the enzyme genes biotransformation - GSTirl, encoding glutathione S-transferase and л1 express almost exclusively in the pulmonary tissue. This gene is located at the locus 11 ql 3, for which repeatedly shown clutch with atopic symptoms. Accumulated in the literature say about the relationship of gene polymorphism FceRI, GSTnl with different allergic diseases.
From this perspective, the study of immunological and genetic mechanisms of the pathogenesis of this disease for the construction of rational treatment and prevention emphasizes the relevance of this thesis research.
From the earliest days of independence, the country has successfully implemented state programs aimed at reforming the health care system. As a result, the targeted implementation of organizational health and research activities aimed at effective diagnosis, prevention and treatment of asthma among adolescents, with some success in the treatment of this disease in the country. However, now the problem of early diagnosis and the development of effective programs for treatment and prevention among adolescents with asthma remain one of the most important issues of modern health care. This research work was carried out in the framework of the tasks set by the Resolution of the Cabinet of Ministers of the Republic of Uzbekistan "On additional measures to improve the health of women and the younger generation," dated 25.01.2002 for the №32. In this regard, the need to deepen the information received about the state of cellular and humoral immunity among adolescents, asking pathogenetic informative immunogcnctic studies in asthma arc one of the important criteria demand the dissertation topic.
Purpose of research is study the immunological and genetic mechanisms of the pathogenesis of asthma in adolescents and form the basis of this plan rational diagnostic and therapeutic measures in this pathology.
In To achieve this goal the following tasks of research is solved:
to establish the clinical course of asthma in the population of adolescents living in the Samarkand region, in the early stages of the pathological process in the bronchopulmonary system.
explore the features of the state of cellular and humoral immunity, as well as activation markers in asthma in adolescence by determining the immunophenotype of lymphocytes in the peripheral blood.
to examine the level of production of immunorcgulatory cytokine interleukin-6 and interfcron-y and install them pathogenetic informative in asthma among adolescents.
to determine the features of distribution of allele and genotype frequencies of polymorphic variants of genes and FceRip GSTnl population Uzbek people with asthma, compared with the healthy part of the population.
examine the clinical and immunological aspects effectiveness of therapies using drugs and polioksidony tsikloferon in patients with asthma in adolescence.
on the basis of studies to develop a multivariate model of formation of bronchial asthma and develop an optimal algorithm for the diagnosis, treatment, prevention in adolescents with this pathological condition.
Scientific novelty of dissertational research consists in the following:
proposed introduction to the work of doctors teen clinics layered approach testing can significantly improve the detection rate of asthma in adolescence and optimize treatment and preventive measures in high-risk groups;
first defined the peculiar characteristics of the quantitative parameters of the immune status of patients with asthma in the cohort of adolescence and the corresponding proposed regulations and guidance documents for the healthy part of the adolescent population;
for the first time presents a comprehensive assessment of the cytokine profile of blood serum in bronchial asthma in adolescents. Specific features of products immunorcgulatory cytokines IL-6 and INF-y and their pathogenetic and regulatory information content in asthma among adolescents;
first analyzed the distribution of alleles and genotypes of polymorphic gene variants and gene FceRip GSTirl among patients with different phenotypic variants of AD and healthy individuals of Uzbek nationality, which resulted in the identified markers of increased risk or, conversely, resistance to the development of asthma in adolescents Uzbek ethnicity;
algorithms for phase diagnosis, treatment and prevention of asthma in adolescence in terms of disclosure of important moments of the pathogenesis of the disease, allowing to build a rational sequence of diagnostic search, aimed at verifying the diagnosis and expedient construction of preventive measures.
Conclusion
1. Set the frequency of occurrence of the disease and the structure of "asthma" in the arid zone among teens. Said pathology is recorded in 9,6% of the population surveyed adolescents, while the disease is more common among females. In the structure of the disease prevails periodical exposure and mild persistent form.
2. Identified by clinical features of asthma among adolescents living in the arid zone, indicate a high frequency of lesions of the bronchial tree association with allergic processes in other organs and tissues: in 73,9% of the AR, 53,7% with AK. 16,6% with BA and 14% with urticaria/angiocdcma.
3. Found that in the study population of patients with asthma adolescence occur expressed disturbances of the immune status, manifested deficit indicators as cell (CD3‘, CD4+, CD8 , CD16+), and humoral immunity (CD19 , IgA, IgG, IgM) and activation markers (CD23+, CD95). The immune status of patients with asthma in young people, adolescence has distinctive features, the depth of detected violations immunoreactivity was most pronounced in the younger age group.
4. In patients with bronchial asthma in adolescence revealed distinct changes in cell-cell interactions in the immune system: a significant increase in the content of Th2-cclls secreted IL-6 is a regulator of maturation of antibodies and immunoglobulin production itself, and vice versa reducing regulator activity of Th 1-cell cytokine INF-y.
5. It was found that the contents of cytokines IL-6, INF-y and in the peripheral blood is in communication with one pathogenic disease. It is shown that the lowest level of INF-y production in the scrum is characteristic of allergic clinical pathogenic variant asthma in adolescence. Adolescents suffering from predominantly infectious form of asthma, there is a sharp trend towards increased production of IL-6 in peripheral blood.
6. Revealed that markers of increased risk of allergic forms of asthma in adolescents Uzbek ethnicity arc genotype FceRip-109T/T allele FceRip-109T, low-risk markers - FcsRip-109C/C and allele Fc£Rip-109C. A high degree of cohesion genotype FcsRip-109T/T allele and FcsRip-109T with hereditary burden of asthma in the Uzbek population.
7. Among females ethnic Uzbek Association revealed lie-105 allele and genotype Ilc-105/Ilc-105 polymorphic gene locus GSTkI at high risk for asthma. Revealed that the genotype associated with the development Ilc-105/Ilc-105 allergic form of asthma in adolescents Uzbek population.
8. Complex therapy with adolescents’ patients with asthma ciklofcron and polyoxidonium, providing immunocorrective effect, enhances the clinical efficacy of basic therapy. In the study of prophylactic efficacy of immunomodulators positive indicators prevailed in the group of patients receiving polioksidony, necessitating its inclusion in the priority scheme of integrated treatment and prevention of asthma in adolescents.
To study the characteristic features of the cellular composition of blood in patients with acute purulent odontogenic ostitis of the jaw. Material and methods: The data obtained during the examination and treatment of 42 patients with acute purulent odontogenic ostitis at the age of 7 to 9 years, who applied to the TGSI clinic, were studied. Results: In the patients, the indices of the red part of the blood were significantly lower than in the comparison group. A low level of hemoglobin can cause hemic tissue hypoxia and affect the state of the acid-base state of the blood, expressed in the form of acidosis, which activates anaerobic glycolysis. An increase in the level of lactic acid in cells can be one of the reasons for the disruption of local microcirculationand the accumulation of endogenous toxins. Conclusions: This pathology is accompanied by a shift in the indicators of the white part of the blood, the observed hemic hypoxia leads to an increase in the level of lactic acid in the cells, which may be one of the reasons for the disruption of local microcirculation and the accumulation of endogenous toxins.
Возможность отрезать антигены с поверхности эритроцитов может помочь в случае недостатка донорской крови первой группы, которая часто бывает наиболее востребованна. Создание искусственной универсальной группы крови позволит решить большую часть проблем с недостатком донорской крови нужной группы в критических ситуациях.
Важное патогенетическое значение в инициации и прогрессировании БА имеет микроциркуляторный блок, составными компонентами которого является гемореологические изменения крови. Главную роль в формировании реологических свойств крови играют эритроциты. Деформируемость эритроцитов имеет решающие значение в регуляции вязкости крови, оказывает существенное влияние на эффективность кровотока на уровне микрососудистого русла и обусловливает способность эритроцитов к транспорту веществ. Основным источником информации об электрическом заряде поверхностной мембраны циркулирующих в крови эритроцитов является метод микроэлектрофареза, основанный на прямо
пропорциональной зависимости между величиной заряда и скоростью его перемещения в постоянном электрическом поле. Данные морфофункционального состояния мембран эритроцитов большую роль играют в плане решения задач ранней диагностики и профилактики многих заболеваний в том числе бронхиальной астмы.
This article provides data on the methods for determining and assessing the trace element status of blood in patients with myopic refraction of varying severity. The paper presents the results of examination of 140 (280 eyes) patients aged 18 to 45 years with various degrees of myopia in order to assess the role of the trace element composition of blood serum, as well as the content of 25 (HO) D in the development and progression of myopia by comparative study of the content of trace elements in serum and their excretion in patients with myopia and emmetropia.
The analysis of the data obtained allows us to draw both theoretical conclusions related to the pathogenesis of progressive myopia and some practical conclusions about the use of the studied parameters as diagnostic criteria in clinical practice when choosing a treatment strategy for patients with progressive myopia.