To study the state of systemic immunity and local immunity before and during chemotherapy in patients with gastric adenocarcinoma.
From 2017 to 2018 at the Tashkent city branch of the Republican specialized scientific and practical medical center of oncology and radiology 20 primary metastatic patients with gastric adenocarcinoma received chemotherapy. The sampling of biological material (peripheral blood, tumor tissue) was carried out twice (before treatment and during the first control examination, after 3 courses). The percentage of the degree of infiltration of tumor tissue by lymphocytes (CD45+CD14-TILs) was estimated by flow cytometry; T cells (CD3+CD19-TILs); B cells (CD3-CD19+TILs); NK cells (CD3-CD16+CD56+TILs); CD16 and CD8 effector cells and their cytotoxic potential (CTP) (CD16+Perforin+TILs; CD16CTPTILs), (CD8+Perforin+TILs; CD8CTPTILs); regulatory T cells - NKT cells (CD3+CD16+CD56+TILs), CD4 (CD4+CD25+CD127-TILs) and CD8 (CD8+CD11b-CD28-TILs) regulatory cells and these parameters of systemic results. The factor of a favorable prognosis for PFS in patients with metastatic gastric cancer in the peripheral blood was an increase in the number of CD8 + T-regulatory cells (5.1% - 12.1%, p = 0.019), and in tumor tissue - an increase in the perforin potential of effector CD16 cells (0.5% - 4.9%, p = 0.030) and their cytotoxic potential (13.2% - 55.7%, p = 0.011). When assessing the changes in the indices of local immunity during chemotherapy, it was noted a negative effect of an increase of T cells (22.0% - -9.7%, p = 0.012), NKT - cells (207.9% - -13.8%, p = 0.002) and CD4 + T-regulatory cells (190.7% - -25.2%, p = 0.002). In contrast, an increase in the level of effector CD16 cells during chemotherapy increases the likelihood of surviving PFS - 9 months (-69.5% - 9.1%, p = 0.013).
Indicators of local and systemic immunity serve as additional prognostic factors for gastric cancer.
Abstract: In this research, the results of the effects of vincamine hydrochloride and pyrozalin iodide alkaloids on the relaxation of aortic smooth muscle cells in the presence of Ca2+ L-channels have been reported. The isometric contraction activity of the aortic blood vessel smooth muscle derived from rabbits was studied using mechanography. The results, under in vitro conditions, demonstrated that the contraction activity of the rabbit aortic blood vessel smooth muscle preparation induced by 50 mM KCl was dependent on the potential of the plasma membrane, associated with the activity of the Ca2*L-channels. It was found that vincamine and pyrozalin iodide alkaloids affected the blockage of the Ca2+i-channels and a reduction in [Ca2*] concentration. The obtained results suggest that the relaxing effect of vincamine hydrochloride and pyrozalin iodide alkaloids is based on the blockage of the L-type Ca2+ channels, and they also affect the receptor-operated Ca2+ channels. In conclusion, the results indicate that in providing the relaxing effect of vincamine and pyrozalin iodide alkaloids, the blockage of potential-dependent L-type Ca2t channels, along with the blockage of receptor-operated Ca2+ channels plays an important role.
The mechanism of action of the alkaloid 1-(2´-bromine-4´,5´-dimethoxyphenyl) - 6,7-dimethoxy-1,2,3,4-tetrahydroisoquinoline (F-18) on the functional activity of smooth muscle cells of the rat aorta was studied. Isometric contraction activity was recorded using a Grass FT – 03 (Grass Instrument, USA) mechanotron. The relaxant effect of the F-18 alkaloid was found to be associated with blockade of Ca2 + (IP3R) channels in the SR, along with voltage- dependent and receptor-operated Ca2+channels in the aorta smooth muscle cell plasmalemma.
Relevance of the problem.Despite the great successes of angiosurgery, the problem of surgical treatment of abdominal aortic aneurysms does not lose its relevance. World health statistics records a steady increase in the incidence of abdominal aortic aneurysm (ABA). According to L.J. Melton et al. (1984) and L.K. Bickerstaff et al. (1984) in the USA the number of patients with abdominal aortic aneurysm has increased 7 times in 30 years since 1951. In England and Wales, according to F.G. Fowkers et al. (1989) for the same period revealed a 20-fold increase in abdominal aortic aneurysms in men and 11-fold in women. According to the results of multicentre screening studies ABA was detected in 8% of the examined (E.S. Vourvouri, 2001), and in the age group of 64-69 years ABA was detected in 5.7% of the examined, and in the age group of 75-81 years - in 8.9% (R.A.P. Skott et al., 2001). A similar trend is observed in other countries. Accordingly, mortality from ABA is also increasing - aneurysm rupture in a number of countries is one of the ten most frequent causes of death among elderly and senile people (F.A. Lederle et al., 1990)
Currently, planned aneurysm resection has become a recognised standard of radical treatment of ABA patients and the number of these operations is steadily increasing. For example, about 40,000 ABA resections are performed annually in the USA (J.J. Grange et al., 1997). In Sweden during the period from 1987-89 to 1993-95 the number of ABA operations increased 5 times and currently 10 operations per 100,000 population are performed (A.Hallin et al., 2001), although this is 1.5 - 2 times less than the required number. However, postoperative lethality is still quite high and makes 5-7% (A.V.Pokrovskiy et al., 1992; Y.V.Belov et al., 1992; V.V.Vakhidov et al., 1992; A.W. Bradbury et al. Bradbury et al., 1997; A.Hallin et al., 2001).
E.W. Steyeberg et al. (1995) summarised the data of literature on 17238 ABA resection operations and gave an average mortality of 6.8%.
Multicentre studies in five major hospitals in the Netherlands found that only 74% of patients underwent ABA resection without complications; 26% had some complications, 9% of which were severe and 4.1% of which were fatal (G.J. Akkersdijk et al., 1998). Similar results were obtained in the Canadian Cooperative Study (K.W. Johnston et al., 1990). It was established that the peculiarity of complications in the majority of patients was their systemic character (L.L. Lau et al, 2001) The course of the postoperative period is most often complicated by cardiac, respiratory, renal, cerebrovascular, as well as complications associated with thrombosis and bleeding (W.E. Lloyd et al., 1996; R.D. Sayers et al., 1997; J.D. Blankenstein et al., 1998; R. Ayari et al., 1998). Ayari et al., 2001)
The undisputed leadership, without doubt, belongs to cardiac complications, the incidence of which varies from 10% to 20%. Moreover, cardiac complications account for 50-70% of total mortality. Cerebrovascular complications, although not uncommon, account for no more than 1-1.5%, but their mortality reaches 40%. Complications associated with thromboses and haemorrhages in the perioperative period reach 2-5% (M.M.Reigel et al., 1987; K.W.Johnson et al., 1990; N.Franklin et al., 1993; A.A.Milne et al., 1994).
Certainly, a large number of complications after resection of abdominal aortic aneurysms is caused by the initial severity of patients' condition, however, many unresolved tactical and technical issues of patients' preparation for the operation, stage of performance in case of combined lesions of several vascular basins play a practically significant role. Adequate management of the operation itself and the immediate postoperative period is no less important, taking into account the possibility of such dreadful complications as thrombosis and embolism, cerebral and cardiac death. Until now there is no unified complex analysis of the results of treatment of uncomplicated abdominal aortic aneurysms and, accordingly, recommendations for the prevention of possible complications.
All this determined our aim and objectives of the study.
The aim of the study is to improve the results of surgical treatment of ABA by developing an effective system for determining the main risk factors of surgical treatment and optimal surgical tactics to prevent possible complications.
Scientific novelty.For the first time a complex analysis of indications and contraindications to surgical treatment of abdominal aortic aneurysms was carried out
The most significant concomitant pathology capable to lead to formidable complications and lethality during the intervention and in the nearest postoperative period was revealed. Adequate measures of their prevention and treatment were proposed.
The algorithm of surgical treatment tactics for patients with combined pathology of coronary arteries and aortic arch branch lesions was developed
The state of haemostasis system at all stages of reconstructive surgery on abdominal aorta, starting from skin incision to wound closure, was studied for the first time.
Conclusions:
1. The proposed original classification of ABA, based on mutual dependence on the etiology of the disease, localisation, concomitant diseases, clinic and its course, allows to determine the strategy of early diagnosis, to estimate the most significant risk factors, the stage of intervention in combined lesions of adjacent and distant vascular basins and, ultimately, to determine the ways to reduce complications and mortality in patients with ABA.
2. The most informative methods of ABA diagnostics are duplex scanning and computed tomography. Non-invasive diagnostics capabilities are enough to determine the aneurysm size, its relation to the renal arteries, as well as to find out the state of visceral branches and aortic bifurcation. Abdominal aortography is indicated in patients with concomitant arterial hypertension to identify the state of the renal arteries.
3. Significant risk factors in these patients are ischaemic heart disease (44.1%), arterial hypertension (49%), haemostasis disorders (almost 100%).
4. The leading concomitant disease in the development of postoperative complications is ischaemic heart disease. Its share in abdominal aortic aneurysms is 40%. Postoperative cardiac complications reach 14.9%. Diagnostics of ischaemic heart disease should be based on the stage-by-stage detection of coronary lesions and its functional-compensatory abilities.
5. The main complications of the postoperative period after ABA resections are acute heart failure (14,9%), cerebral circulatory disorders (1,5%), acute renal failure (3,33%).
6. When significant coronary vascular channel lesions are detected in patients with ABA, it is fundamental to solve the issue of intervention staging. At 3-4 functional classes of circulatory insufficiency, appearance of new zones of hypo- or akinesia, decrease of ejection fraction below 40%, the first stage should be myocardial revascularisation surgery
7. In patients with combined lesions of brachiocephalic vessels in patients with ABA it is reasonable to assess the cerebral blood flow. In the presence of 70% or more stenosis of VCA, presence of embologenic plaque, bilateral haemodynamically significant stenosis it is necessary to perform carotid artery intervention as the first stage.
8. One of the most difficult problems of reconstructive operations in ABA is the contiguous lesion of renal and visceral branches of the abdominal aorta. The principle is their one-stage reconstruction. The types of reconstruction of these branches should be variable depending on the volume and extent of the pathological process.
9. Patients with aneurysmal lesion of abdominal aorta initially always have significant disorders of haemostasis system. In 30% of patients with occlusive diseases of aorta and its branches in the preoperative period the activity of thrombocytic-vascular link of hemostasis is increased, antithrombotic ability of vascular wall endothelium is decreased and blood rheological properties are disturbed. Activation of fibrinolysis was noted in patients with aneurysmal lesion of abdominal aorta.
10. During the operation for abdominal aortic aneurysmal lesion, after starting the blood flow the level of plasminogen increases additionally by 30%, which is a risk factor for haemorrhagic complications in the perioperative period. On the 1-3 day after the operation there is a significant decrease of blood anticoagulant potential - antithrombin-Sh by 25-27%, protein C by 23-25%. This period is the most dangerous in terms of thrombohemorrhagic complications development.
11. When using standard heparin during the operation there is a consumption of antithrombin-Sh by 30-45% and increase of platelet aggregation by 10%, which is a threatening condition for the occurrence of thrombosis of deep veins of the lower extremities with subsequent TELA. When using fraxiparin during reconstructive vascular surgeries the consumption of antithrombin-Sh and increase in platelet aggregation do not occur, prothrombin time, activated partial thromboplastin time, thrombin time are lengthened insignificantly that testifies to expediency of its use for prevention of thrombohemorrhagic complications.
12. Application of the diagnostic methods proposed by us to detect the main risk factors during the operation and in the nearest postoperative period, use of the algorithm of stage and volume of intervention allowed to reduce significantly the number of threatening complications, thus the lethality decreased 4 times, and the number of non-fatal complications - 4 times non-fatal complications - 1.5 times.
A substitution mallow vascular plant 'Tohagol Red' with particular bloom structure and variety, uniform development propensity and vigor was created through interspecies matching between mallow sinosyriacus and H. syriacus. a substitution vascular plant 'Tohagol Red' (Hibiscus × 'Tohagol Red') grew once going between mallow sinosyriacus 'Seobong' ( ♀) with pink bloom and rose of Sharon 'Samchully' with pink blossom to help blossom quality and development propensity. mallow 'Tohagol Red' was for starters picked as 'R 202' for its steady bloom quality with well off pink blossom and unsettled botanical leafs. This vascular plant had violet purple, unsettled blossoms complemented by partner degree extraordinary red eye. goliath and ostentatious, the covering bloom petals designed an entire circle thus named 'Tohagol Red'. The tree showed medium development propensity with somewhat upstanding branch. the picked line was any assessed for different development attributes, leaf shape, leaf size, blooming qualities, and tried for uniqueness, homogeneity, and soundness all through. inside the blossoms region unit medium in size (11 ~ thirteen cm) with fan (II-type) botanical leaf having aspect nine.2 cm. Leaves region unit seven.2 cm long and five.4 cm wide. when the plant qualities investigation for a considerable length of time (2014 ~ 2019), it had been enrolled as a vascular plant 'Tohagol Red' (3803, No. of plant determination assurance freedoms) in 2020. 'Tohagol Red' having violet-purple blossom and red eye with unsettled petals is a magnificent vegetation.
Presence of Сirculating tumor cells (CTCs) in blood of disease patients, affirms about a
scattering of malignant growth cells to the fringe circulatory system, on the most punctual
phases of malignancy improvement and all the time vouches for an unfavorable clinical ebb
and flow, particularly it is associated with arrangement of metastases. Moreover, these
phones can speak to the base lingering infection and quantitative observing of CTCs level in
time of hostile to malignant growth treatment furnishes specialiCDC with important data. For
now the job of epithelial-to-mesenchymal travel (EMT) and mesenchymal-to-epithelial travel
(MET) in arrangement of different subpopulations CTCs, in development of malignancy
forceful properties. In this article we need to demonstrate the reason and issues of our
logical exploration - the cytological atomic investigation of flowing tumor cells have
separated by the size ward ISET innovation.
When an autologous fascia is placed on the drum membrane, at first all kinds of reactive changes develop around it, and in a short period of time a border of demarcation from lympho-histiocytic and monocyto-macrophage cells appears, but these cells do not grow into the fascia, on the contrary, a fibrous membrane appears around it, its surface on the 21st day completely epithelized. When the pericardium of the sheep heart is transplanted into the tympanic membrane for the purpose of closing it, a strong and extensive reactive change develops in response. Necrosis and destruction develop in the xenograft, and a proliferative infiltrate appears around it. Then the xenograft intermingles with the proliferative infiltrate cells that appear around the tissue structures. Young lympho-histiocytic cells turn into fibrocytes and histiocytes, produce fibrous structures and the surface is covered with epithelium.
This study explores the optimization of passivation techniques for monocrystalline solar cells through the assessment of carbon content in silicon-carbon alloys. Passivation layers play a critical role in enhancing the efficiency and performance of solar cells by reducing recombination losses at the semiconductor surface. Silicon-carbon alloys offer a promising avenue for passivation due to their tunable properties and compatibility with existing manufacturing processes. By systematically varying the carbon content in silicon-carbon alloys, this research investigates its impact on passivation quality, surface recombination velocity, and photovoltaic device performance. Characterization techniques such as spectroscopic ellipsometry, surface photovoltage measurements, and photoluminescence imaging are employed to assess passivation layer thickness, interface quality, and carrier lifetime. The findings provide valuable insights into the role of carbon content in optimizing passivation effectiveness and offer pathways for enhancing the efficiency and stability of monocrystalline solar cells.
This article describes the physiological characteristics of muscle tone and the impact of muscle tone disorders on human health.
Effect of dihydroatizin (5–250 μmol / L) on the contractile activity of rat smooth aorta muscle cells (SMC). Isometric tensile forces were recorded. Using a force transducer FT - 03 (Grass Instrument Co., USA). In it was found by experiments that the vasodilating effect of dihydroatizin mainly associated with the blockade of the Ca2 + L-channel.
Methods-Preparation of the aortic vessel muscle preparation, and recording the force of contraction.
Results- KCI-induced contraction of the aortic MMC is associated with the activation of potential–dependent Ca2+L channels of the plasma membranes of the MMC
Conclusions- The data obtained as a result of studying the mechanisms of action of the alkaloid dihydroathysine are of great practical importance and can be recommended for optimizing the process of purposeful creation of a new generation of vasorelaxant drugs.