Method for predicting clinical course of pyo- inflammatory disease in extremities

FIELD: medicine.

SUBSTANCE: method involves taking blood from ulnar vein (systemic blood circulation) and from large vein of the injured extremity proximal with respect to lesion focus (regional blood circulation). Spontaneous NST-test value is determined and difference is calculated in systemic and regional blood circulation as regional-to-systemic difference. The difference value is used for predicting clinical course of pyo-inflammatory disease in extremities.

EFFECT: high accuracy of diagnosis.

4 cl, 2 tbl

 

The invention relates to medicine, namely to surgery, and can be used in the treatment of patients with purulent-inflammatory diseases of the extremities.

The problem of treatment of purulent-inflammatory diseases continues to be relevant. According to Vagelatos et al. [1]. Vntruth et al. [2] purulent-inflammatory diseases in the structure of surgical pathology reach 30%. Purulent diseases of the extremities constitute 20% of all purulent diseases, and their treatment is a difficult task [3].

Widespread known way to assess severity and predict the course of chronic inflammatory diseases (including diseases of the extremities), based on the assessment of the activity of inflammation by determining the total leukocyte count and count distinct forms - leukocyte index of intoxication on Jail-Caliph [4].

In this way the normal index of intoxication is 0.7; the increase correlates with the severity of the inflammatory process, and forecast to become more severe in terms of complications and outcomes. After conducting effective treatment indicator leukocyte index of intoxication decreases, approaching normal.

However, this method of diagnosis is not always adequate information on the range of situations in inflammation, not possible to objectively judge the activity, the resolution or remission process [5]. The situation in the area of inflammation may be active, be accompanied by a sharp destruction, and the number of leukocytes in the blood to grow will not, often it is even decreasing due to inhibition of the formation of leukocytes in the bone marrow (true leukopenia, until the “right shift”), or fixation of leukocytes on the vascular wall (false leukopenia) in sepsis. In addition, the use of this indicator for the prediction of disease outcome is more difficult as the prognosis worsens with increasing severity for this indicator without assessing the adequacy of response to inflammation, the function of leukocytes. Inflammation is a local response of the body, thus, the study of blood counts in the total flow does not fully reflect its activity.

Recently developed methods for predicting the course of inflammatory diseases, based on the study of the functional activity of neutrophils, which is one of the most common effector mechanisms of homeostasis.

A prototype of the invention is selected there is a method of predicting the course of purulent-inflammatory diseases of the extremities, including the study of functional activity of neutrophils of blood through the reaction of no is of nitrocine of tetrazole (NBT-test) [6] (Geigenbau, Kmetija Using NBT-test with neutrophils of peripheral blood for prediction of prolonged and complicated course of faces // Questions of clinical immunology and immunological diagnostics. - Alma-ATA, 1988. - Pp.109-112). In the method prototype prognosis of chronic inflammatory diseases (i.e. faces) are indicators of spontaneous and induced NBT-test, namely the dynamics of the rate of spontaneous NBT-test (snst-test) and the value of the index of inhibition, representing the ratio of the percentage of NBT-test, a sample of blood donor, to which was added the serum of a healthy person, blood donor, to which was added the serum of the patient. When this adverse prognostic features are stubbornly low performance snst-test (less than 10%) or rapid collapse of the initially high values and the low value of the index of inhibition (0,64±0,06) compared with those with a favorable outcome (0,92±0,06). The disadvantages of the method prototype, requiring further improvement of the method include the following:

the forecasting accuracy is not sufficiently high: so, the criterion of low values of the indicator snst-test (less than 10%) adverse outcome was confirmed only half of the patients (50%); according to the criterion sharp drop in performance snst test blagopri is fair prediction was confirmed in 75% of cases; according to the criterion of the index of inhibition mismatch prediction was observed in 20-30% of patients;

- prototype method does not enable prediction in the early stages (before treatment), as it requires for its implementation of the monitoring of the dynamics of the show gels during the course of treatment;

- prototype method is technically difficult being implemented in parts of the definition of the parameter as an index of inhibition (complex technique requiring moreover, not only with the blood of the patient, but also healthy people);

- prototype method has limited use (criterion developed for only one disease - erysipelas).

The task of the present invention, it should: improve the accuracy of predicting the course of purulent-inflammatory diseases; the ability to predict in the early stages (before treatment); the simplification and acceleration of way; extending the scope of application of the method due to the possibility of use in various inflammatory diseases (acute and chronic post-traumatic osteomyelitis, cellulitis).

The task in the way of predicting the course of purulent-inflammatory diseases of the extremities, including the study of the functional activity of blood neutrophils using a reduction reaction of nitrocine of tetrazole (Stesta), is achieved by the fact that the blood test done before treatment and after treatment, blood samples taken from the cubital vein (systemic circulation) and of the main venous trunk of the affected limb, proximal to the lesion (regional blood flow)in each blood sample to determine the rate of spontaneous NBT-test (snst-test), then calculate the difference between the spontaneous NBT-test in regional and systemic blood flow (regionalna-system difference - PCP) and PCP is as follows predict the course of purulent-inflammatory diseases:

- forecasting in the early stages:

positive value PCP before treatment predict uncomplicated and nesacaine duration of the process, as well as the possibility of a lack of chronicity of the process and relapse after treatment;

when a negative value PCP before treatment predict a complicated and protracted process, and the ability of the chronicity of the process and relapse after treatment;

- forecasting in the late stages:

positive value PCP after treatment predicts the absence of the chronicity of the process and relapse;

when a negative value PCP after treatment predict

chronization process and relapse;

figure NBT-test is predelay as the percentage of cells containing in the cytoplasm inclusion of deformazione 200 neutrophils: additionally they control the effectiveness of treatment and sufficient treatment effectiveness is judged by a reduction to the level of healthy individuals is indicative NBT-test after treatment compared with those before treatment; additionally assess the reserve capacity of the neutrophils on the metric induced NBT-test traditional method and a favorable prognosis is judged while maintaining the functional reserve of neutrophils; in the case of conduct in the course of treatment is amputation of the affected limb prediction in the later stages carried out as follows:

positive value PCP predict a quick and uncomplicated wound healing, negative value PCP - long or complicated.

The authors of this application studied indicators of functional activity of neutrophils in the blood from a vein of the elbow bend (systemic circulation) and from Vienna affected limb (regional blood flow) was performed in 18 patients with various inflammatory disorders. The age of patients ranged from 19 to 64 years. Men 14, women 4. In 15 cases of purulent process was localized to the lower extremities, 3 on the top. With exacerbation of chronic posttraumatic osteomyelitis (HPTO) there were 9 patients with acute posttraumatic the definition osteomyelitis (OPTO) - 6 patients with deep phlegmon - 3 patients. In the study of these tests in patients concurrently they have been studied in systemic blood flow and regional level in 20 healthy persons.

Indicators of spontaneous and induced activity of polymorphonuclear leukocytes by NBT-test in healthy individuals in systemic and regional blood flow was not significantly different (spontaneous NBT-test in systemic blood of 10.75±0,72%, regional - 10,55±0,63%induced nst-test in systemic blood - 70,05±1,64%in regional - 69,2±1,29%). According to JN. Mayansky [5], the system flow rate of spontaneous NBT-test does not exceed 10-12%. In the analysis of spontaneous NBT-test patients before treatment were significant differences in the performance of this test in systemic and regional blood flow. In 10 patients the indicators SST test in the blood of the affected limb were higher than in systemic blood flow (p<0,05), in 8 patients the indicators SST in systemic blood exceeded these indicators in regional blood flow (p<0,01). In accordance with the detected difference patients were divided into 2 groups of 10 patients with a positive regionalna-system difference (PCP) SST and 8 patients with a negative. Indices nst-test patients of both groups in systemic and regional blood flow was significantly higher than in healthy individuals (see table 1 and 2).

Table 1

The values of spontaneous and induced activity of polymorphonuclear leukocytes by NBT-test before, during and after treatment (in group I patients
snst (%)PCP

(put., a negative.)
inst(%)
the blood systemregional blood flowthe blood systemregional blood flow
Before the treatment17,1±1,4327,1±2,22I promise.67,5±3,1372,8±1,59
After the treatment15,3±1,7218,5±2,09I promise.64,3±2,5368,4±1,85
Healthy peopleof 10.75±0,7210,55±0,63-70,05±1,64b,2±1,29

Table 2

The values of spontaneous and induced activity of polymorphonuclear leukocytes by NBT-test before, during and after treatment () in group II
snst (%)PCP

(put., a negative.)
inst (%)
the blood systemregional blood flowthe blood systemregional blood flow
Before the treatment27,63±1,9818,5±2,5a negative.67,86±2,1360,63±2,80
After the treatment14,5±1,3212,12±,063a negative.69,38±1,7863,5±of 2.51
Healthy peopleof 10.75±0,7210,55±0,63-70,05±1,6469,2±1,29

In the analysis of clinical treatment outcomes found that patients of group I of the inflammatory process was stopped in all cases, not subsequently noted the chronicity of the process or recurrence of the disease. In patients of group II was observed adverse inflammatory process in 6 cases out of 8: 3 was observed prolonged healing of wounds, 2 - performed the amputation of limbs, in 1 case, it was a relapse of chronic posttraumatic osteomyelitis in terms of up to 6 months. In cases when you have performed the amputation was observed wound healing in different terms: one for 12 hours, the other wound healing occurred in the period up to 1 month.

All surveyed necessarily held control of the effectiveness of treatment, as uh what about the need for so in case you need to adjust therapy, to enhance antibacterial therapy, etc.

Monitoring the effectiveness of treatment was carried out to reduce to the level of healthy people indicators NBT-test after treatment compared with those before treatment. An assessment of the effectiveness of treatment thus explained by the fact that when the subsidence of the inflammatory process decreases the number of factors that stimulate the production of reactive oxygen species by neutrophils blood that is logged on reducing rates of spontaneous NBT-test.

As can be seen from the table. 1 and 2, in both groups of patients there is a decrease in performance snst-test, which indicates the subsidence of the inflammatory process and, accordingly, about the effectiveness of the treatment.

In addition, all patients were additionally evaluated the reserve capacity of the neutrophils on the metric induced NBT-test. The need for this additional assessment due to the fact that induced variant NBT-test reflects the availability of reserves biocenose, and low rates inst-test say about hereditary defect in the education system, the active form of oxygen, or depletion of cells. In case of reduction of the reserve, apparently, should imply inadequate cell response and expect neblagopriyatna the th course of the inflammatory process, he will be sluggish, and can be torpid course. Normal indicator tool should exceed the rate snst.

As can be seen from the table. 1 and 2, patients of both groups was observed high rates of induced NBT-test, which was due to the presence of the infection, the backup ability of neutrophils was preserved in all cases.

The proposed method is as follows. In patients with purulent-inflammatory process is localized on a limb, when are drawing blood from a vein of the elbow bend (systemic circulation) and main veins of the affected limb (regional blood flow), which determine the performance of spontaneous and induced NBT-test method ragc: NR. et al. [7], in the modification Mejicana and Annanicole [8, 9]. It consists of the following: produce a sampling of capillary blood or blood from a vein of the elbow bend. In siliconized tubes contribute to 0.05 ml of blood in the test tube (the study of spontaneous reaction) is added to 0.025 ml of isotonic phosphate buffer pH 7.2, experienced (stimulated reaction) 0,025 ml stimulator (microbial suspension Srrti mrsns, FMA (forpolitical), opsonizing zymosan). Then all the tubes make a 0,025 ml of 0.2% solution narasinga of tetrazole. The contents of the test tubes thoroughly mixed, p is opening a plastic glass, moistened with phosphate buffer, and incubated in thermostat 30 min at a temperature of 30°C. After incubation the contents of the test tubes again mix and prepare smears, drying them in the air. Smears fixed for 1 min in ethanol (96)-formalin (40%) solution (in a ratio of 1:9). Cell nuclei stained in 2% solution of methyl green for 7-10 min the result is assessed through immersion microscopy by determining the index of stimulation of neutrophils. The calculation is 200 neutrophils. Take into account the percentage of cells containing granules of deformazione.

Re-analysis is performed after the end of treatment. Assess the levels before treatment, the different indicators of spontaneous NBT-test in systemic and local blood flow, dynamics and regionalna-system difference (PCP) during and after treatment. The definition of PCP spend each time as follows: from figure SST test in regional blood flow subtract indicator SST test in systemic blood

PCP=cnstregionen-snstsist.

According to the obtained data on the amount of PCP spend the prediction of flow and at the same time:

- in the early stages:

positive value PCP before treatment predict uncomplicated and nesacaine duration of the process, as well as the possibility of a lack of chronicity of the process and relapse is the ass end of treatment;

when a negative value PCP before treatment predict a complicated and protracted process, and the ability of the chronicity of the process and relapse after treatment;

- in the later stages:

positive value PCP after treatment predicts the absence of the chronicity of the process and relapse;

when a negative value PCP after treatment predict chronization process and relapse;

figure NBT-test is defined as the percentage of cells containing in the cytoplasm inclusion of deformazione 200 neutrophils; in addition, they control the effectiveness of treatment and sufficient treatment effectiveness is judged by a reduction to the level of healthy individuals indicators NBT-test after treatment compared with those before treatment; additionally assess the reserve capacity of the neutrophils on the metric induced NBT-test traditional method and a favorable prognosis is judged while maintaining the functional reserve of neutrophils; in the case of conduct in the course of treatment is amputation of the affected limb prediction in the later stages carried out as follows:

positive value PCP predict a quick and uncomplicated wound healing, negative value PCP - long or complicated.

Additionally Provo is Yat evaluation of the effectiveness of treatment, what is important for timely correction of the treatment.

Evaluation of the effectiveness of the treatment carried out as follows: compare the spontaneous NBT-test before the course and after treatment in systemic and regional blood flow, adequate treatment effectiveness is judged by a reduction to the level of healthy individuals indicators NBT-test after treatment compared with those before treatment.

To predict the course of chronic inflammatory diseases it is necessary to assess the reserve capacity of neutrophils to talk about the adequacy of the response of neutrophils to a stimulus, because of the low inst-test should inadequacy cell response.

Assessment of the reserve capacity of neutrophils carried out according to the standard technique according to the results of stimulated NBT-test as follows: from figure inst-test subtracts the corresponding figure SST-test:

reserve=inst - snst

Examples of specific performance of the method is given in the form of extracts from the histories.

Example No. 1.

Patient Z., IB. No. 0204266, 50 years old, he enrolled in the clinic of General surgery. A.I. Kozhevnikova 25.02.01, about exacerbation of chronic post-traumatic osteomyelitis, right tibia, which developed after open fractures of both ankles and the rear edge of the tibial KOs is right. Repeated courses of antimicrobial therapy, earlier, had no success. When applying the indicators SST in systemic and regional blood flow was 29% and 25%, respectively (i.e. PCP negative), the performance of the tool has reached 73%, indicating that the saved backup capabilities. Early prediction - the patient is expected unfavorable course of the disease. The patient underwent surgery performed catheterization deep artery, circumflex iliac bone to the right, readjustment of purulent infection in the distal tibial metaphysis, hardware fusion of right ankle, started intraarterial infusion therapy. Part of infusate included antibiotics sensitivity isolated from purulent microflora. On the background of the treatment was observed normalization of hematological parameters, body temperature. It was noted prolonged wound healing at the time of discharge was kept wound 2×2 cm, the bottom of which granulation tissue covering the bone, i.e. the early prediction was confirmed. At discharge indicators snst fell to 12 in regional and 13% in systemic blood (approached indices in healthy individuals)that the testimony of the effectiveness of the treatment. In terms of up to 6 months came recurrence of the disease, which required a second surgical cured the I, i.e. the prediction was confirmed.

Example No. 2.

Patient S., IB. No. 02120173, 39 years old, was admitted to the hospital 20.08.2001 for acute post-traumatic osteomyelitis, right tibia, as a complication open comminuted fracture of both bones of the right leg. When applying the indicators SST in systemic and regional blood flow 14% and 35%, respectively, PCP positive, indicating that favorable early forecast, uncomplicated process. Backup the ability of neutrophils according to the inst-test was saved (inst 56% and 74%, respectively). Started intraarterial infusion therapy, later performed surgical rehabilitation of purulent infection, the right tibia osteosynthesis by Ilizarov. The wound in the leg was partially sutured. The composition introduced into the arterial tree of infusate was selected individually. In accordance with the results of microbiological studies of discharge from the wound. On the background of treatment was observed clinical improvement, lower body temperature, normalization of blood counts, wound healing in terms of up to 14 days, early prediction was confirmed. After treatment marked decline snst to 12 in the system and 19% in regional blood flow (positive PCP), respectively. The treatment is regarded as effective. Further about the LCM was regarded as favorable, i.e. predicted absence in subsequent chronicity and recurrence of the disease. In the subsequent came a consolidation of the fracture, the Ilizarov apparatus was dismantled. Recurrence of the disease up to the present time is not checked.

Example No. 3.

Patient R., IB. No. 01/21484, 21, was admitted to the hospital 25.09.01, regarding non-consolidated fracture of the right humerus, complicated with chronic posttraumatic osteomyelitis (active form). When applying the indicators snst amounted to 25% in systemic blood flow and 20% in regional (PCP negative), when stored reserve according to the inst-test, as the rate reached 60% and 52% respectively. The original forecast regarded as unfavorable. Patient was operated, performed the catheterization of the chest-acromiale artery produced sanitation purulent infection, application of the right humerus by Ilizarov. Started intraarterial infusion therapy. Antibiotic therapy was carried out in accordance with antibiotic resistance isolated from the source of microorganisms. The postoperative course was unremarkable, the wound on his shoulder healed by first intention, the sutures were removed on the 12th day. When the control NBT-test, found that the rate approached indices in healthy individuals, the treatment is regarded as effective. In reg is opened the flow snst - 12%, system - 8% (positive PCP). Further forecast regarded as favorable. Subsequently, the patient came a consolidation of the fracture, the Ilizarov apparatus was dismantled. To date relapse is not selected, that is, the forecast for later dates are confirmed. With regard to the fact that early prediction is not confirmed, it is due to the fact that the results are negative PCP was reinforced antibacterial therapy, replacement of the antibiotic lincomycin on a wide spectrum of abaktal.

Example No. 4.

Patient K., IB, No. 0114172, 28 years old, was admitted to the hospital 19.06.01, about open comminuted fracture of the left forearm, complicated putrid abscess of the left forearm and shoulder. When applying the indicators snst-test was 29% in systemic blood flow and 12% in regional (PCP negative) when the saved backup capacity (inst 65% and 59%, respectively), prognosis before treatment is regarded as unfavorable. The patient made catheterization graduaciones artery, performed the resection of the upper third of the ulnar bone, necrectomy on forearm and shoulder. Started intra-arterial infusion therapy with the introduction of broad-spectrum antibiotic - Tienam. Despite treatment, the positive dynamics in the patient's condition and with the pile-RAS were observed. Was performed amputation of the left shoulder in the middle third. Postoperative intra-arterial infusion was continued, using abaktal and metrogel. After treatment, re-analysis of indicators of NBT-test. Marked decline snst-test to the level of healthy persons - 12% in systemic blood flow and 10% in the regional. speaking of the subsidence of the inflammatory phenomenon and, accordingly, about the effectiveness of therapy. PCP remained negative, reserve capacity of neutrophils saved (73% and 70%, respectively), that is predicted prolonged or complicated wound healing. Wound healing occurred in the period up to 1 month, that is, the forecast for late has confirmed.

Sources of information

1. Devyatov V.V., Petrov S.V. Microbial contamination of wounds and the prevention of suppurative complications /Surgery. - 1992. No. 7-8. - P.70-74.

2. The French NR. Intra-arterial infusion of drugs in the treatment of purulent-inflammatory processes of the upper extremities. / Reconstructive and new methods of treatment in the clinic. - M.: Voenizdat, 1989. - P.65-66

3. Kazarinov M.V., Morgunov GA, Queen A. M.,Korolev, I.I., Bergen V.O., Filippov AT Ways to improve care for patients with purulent surgical diseases. Journal of surgery 1995; 154(4-6): 92-93.

4. Murashev SM Changing lake is sitenovo intoxication index in the pre - and postoperative period in patients with cholecystitis // Sov. medicine. - 1975. No. 2. - S.112-116.

5. Mayansky, D.N., Ursov I.G. Lectures on clinical pathology. - Novosibirsk, 1987, 76-85.

6. Sagimbaeva G., Tutaev K.M. Using NBT-test with neutrophils of peripheral blood for prediction of prolonged and complicated course of faces // Questions of clinical immunology and immunological diagnostics. - Alma-ATA, 1988. - Pp.109-112.

7. Ragc V.N., Firkig S.. Smitwick E.M. Inftin and mitroblue ttrzlium reduction by nutrohilis. Lnt 1968; (2): 532-534.

8. Wixman M.E. Ter-Minassian, mayansky A.N. Kazan medical journal 1977; 58(5): 99-100.

9. Wixman M.E. Ter-Minassian, mayansky A.N. The way to assess the functional activity of human neutrophils by the reaction of recovery narasinga of tetrazole: methodical recommendations. Kazan; 1979: 12 C.

1. A method of predicting the course of purulent-inflammatory diseases of the extremities, including the study of the functional activity of blood neutrophils using a reduction reaction of nitrocine of tetrazole (NBT-test), characterized in that take blood from the cubital vein (systemic circulation) and of the main venous trunk of the affected limb, proximal to the lesion (regional blood flow), determine the rate of spontaneous NBT-test (snst-test) and calculate the difference between SST test in regional and systemic blood flow (regionalna-system difference - PCP) and the P value Is P predict the course of purulent-inflammatory diseases of the extremities.

2. The method according to claim 1, characterized in that the determination of PCP is carried out before and after treatment and at a negative value PCP predict a complicated and protracted process, and the possibility of relapse and chronicity of the process.

3. The method according to claim 1, characterized in that for monitoring the effectiveness of treatment is additionally carried out targeting SST-test after treatment and reducing them to the level of healthy individuals demonstrated adequate treatment.

4. The method according to claim 1, characterized in that when the prognosis of chronic inflammatory diseases with amputation of the affected limb negative value PCP indicates a long or complicated disease course.



 

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3 ex

FIELD: medicine, clinical toxicology.

SUBSTANCE: at patient's hospitalization one should gather the data of clinical and laboratory values: on the type of chemical substance, patient's age, data of clinical survey and laboratory values: body temperature, the presence or absence of dysphonia, oliguria being below 30 ml/h, hemoglobinuria, erythrocytic hemolysis, exotoxic shock, glucose level in blood, fibrinogen and creatinine concentration in blood serum, general bilirubin, prothrombin index (PTI), Ph-plasma, the state of blood clotting system. The state of every sign should be evaluated in points to be then summed up and at exceeding the sum of points being above "+20" one should predict unfavorable result. At the sum of "-13" prediction should be stated upon as favorable and at "-13" up to "+20" - prediction is considered to be doubtful.

EFFECT: higher accuracy of prediction.

2 ex, 3 tbl

FIELD: medicine, juvenile clinical nephrology.

SUBSTANCE: disease duration in case of obstructive pyelonephritis should be detected by two ways: either by detecting the value of NADPH-diaphorase activity, as the marker of nitroxide synthase activity in different renal department and comparing it to established norm, or by detecting clinico-laboratory values, such as: hemoglobin, leukocytes, eosinophils, urea, beta-lipoproteides, lymphocytes, neutrophils, the level of glomerular filtration, that of canalicular reabsorption, urinary specific weight, daily excretion of oxalates, arterial pressure, and estimating their deviation against average statistical values by taking into account a child's age.

EFFECT: higher efficiency of detection.

7 dwg, 1 ex, 6 tbl

FIELD: clinical medicine, pulmonology.

SUBSTANCE: one should carry out complex estimation of interleukin-1β) concentration in blood, saliva, bronchoalveolar liquid. Moreover, one should detect distribution coefficient (DC) for IL-1β as the ratio of IL-1β blood content to IL-1β salivary content. At increased IL-1β blood content by 10 times and more, by 2 times in saliva, unchanged level of bronchoalveolar IL-1β, at DC for IL-1β being above 1.0 one should predict bronchial obstruction. The method enables to conduct diagnostics of the above-mentioned disease at its earlier stages.

EFFECT: higher efficiency of prediction.

2 tbl

FIELD: medicine, diagnostics.

SUBSTANCE: the present innovation deals with genetic trials, with diagnostic field of oncological diseases due to analyzing DNA by altered status of gene methylation that take part in intracellular regulation of division, differentiating, apoptosis and detoxication processes. One should measure the status of methylation in three genes: p16, E-cadherine and GSTP1 in any human biological samples taken out of blood plasma, urine, lymph nodes, tumor tissue, inter-tissue liquid, ascitic liquid, blood cells and buccal epithelium and other; one should analyze DNA in which modified genes of tumor origin or their components are present that contain defective genes, moreover, analysis should be performed due to extracting and purifying DNA out of biological samples followed by bisulfite treatment of this DNA for modifying unprotected cytosine foundations at keeping 5-methyl cytosine being a protected cytosine foundation followed by PCR assay of bisulfite-treated and bisulfite-untreated genes under investigation and at detecting alterations obtained according to electrophoretic result of PCR amplificates, due to detecting the difference in the number and electrophoretic mobility of corresponding fractions at comparing with control methylated and unmethylated samples containing normal and hypermethylated forms of genes one should diagnose oncological diseases. The method provides higher reliability in detecting tumors, detection of remained tumor cells after operation.

EFFECT: higher efficiency of therapy.

1 cl, 3 dwg, 4 ex

FIELD: medicine, gastroenterology.

SUBSTANCE: one should carry out diagnostic studying, moreover, on the 5th -6th d against the onset of exacerbation in case of gastric and duodenal ulcerous disease one should detect the content serotonin, histamine and acetylcholine in blood, then during 2-3 wk one should conduct medicinal therapy to detect serotonin, histamine and acetylcholine level in blood again and at serotonin content being by 2-3 times above the norm, histamine - by 1.15-1.4 times above the norm and acetylcholine - by 20-45% being below the norm one should predict the flow of gastric and duodenal ulcerous disease as a non-scarring ulcer.

EFFECT: higher accuracy of prediction.

3 ex

FIELD: medicine.

SUBSTANCE: method involves taking blood from ulnar vein (systemic blood circulation) and from large vein of the injured extremity proximal with respect to lesion focus (regional blood circulation). Spontaneous NST-test value is determined and difference is calculated in systemic and regional blood circulation as regional-to-systemic difference. The difference value is used for predicting clinical course of pyo-inflammatory disease in extremities.

EFFECT: high accuracy of diagnosis.

4 cl, 2 tbl

FIELD: medicine, gastroenterology.

SUBSTANCE: one should introduce biologically active substance, moreover, in patient's blood serum one should detect the content of acetyl choline and choline esterase activity followed by 2-h-long intragastric pH-metry at loading with biologically active substance as warm 40-45%-honey water solution at 35-40 C, and at increased content of acetyl choline being above 1.0 mM/l, choline esterase being above 0.5 mM/l/30 min and pH level being 6.0-6.9 it is possible to consider apitherapy to be useful for treating ulcerous duodenal disease.

EFFECT: higher efficiency and accuracy of detection.

3 ex

FIELD: medicine, gastroenterology.

SUBSTANCE: it has been suggested a new method to detect pharmacological sensitivity to preparations as acidosuppressors. After the intake of the preparation a patient should undergo fibrogastroduodenoscopy 3 h later, then, through endoscopic catheter one should introduce 0.3%-Congo red solution intragastrically and the test is considered to be positive at keeping red color that indicates good sensitivity to the given preparation, and in case of dark-blue or black color the test is considered to be negative that indicates resistance to this preparation. The suggested innovation widens the number of diagnostic techniques of mentioned indication.

EFFECT: higher efficiency of diagnostics.

2 ex

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