Method for protecting ischemized liver
FIELD: experimental medicine.
SUBSTANCE: in rabbits one should induce hepatic ischemia due to occlusion of hepato-duodenal ligament for 30 min. Moreover, reamberin should be introduced at the dosage of 35 ml/kg during the whole period of occlusion, and at the dosage of 5 ml/kg for 10 min after removing the above-mentioned occlusion. The method provides preventing the death of experimental animals in case of ischemic exposure being harmful for this type of animals.
EFFECT: higher efficiency of protection.
The invention relates to medicine and can be used in hepatobiliary surgery, in particular for liver resections.
In a similar experimental and clinical works temporary ischemia of the liver is achieved by compression of the hepato-duodenal ligament (MPD). For anti-ischemic protection of the liver is vnutriaortalina hypothermic perfusion of the standard polygon solutions, in some studies with oxygenation of the solution and the addition of colloidal plasma substitutes [2, 7].
The disadvantages of transfused environments depending on the quality of the infusion solution should be attributed to the lack of a comprehensive anti-ischemic actions, involving simultaneous antihypoxic, anti-oxidant, energymetabolism and detoxification properties. In addition, conducting regional hypothermic perfusion of the liver polygon solutions during ischemia has its methodological features and is used to narrow the field of liver surgery for certain types of operations associated with total vascular exclusion of the body.
For the prevention and cessation of bleeding in surgical interventions and injuries of the liver is widely used receiving temporary full pinched PDS. Bleeding and blood loss are one of the main problems surgical is th Hepatology. Therefore, temporary (for the period of implementation of the surgical hemostasis) clamping of the PDS refers to the number of common techniques used in the resection and liver injury. However, even short-term clamping of the MPD is a dangerous admission, causing severe ischemic liver damage, stagnation of blood in the portal system with the buildup of stagnant toxemia in the portal vein, the emergence of the phenomenon of reperfusion liver injury excessive inflow mycotoxins stagnant blood CNC bed at eliminating the occlusion ELVs rough systemic hemodynamic . This causes, according to most authors, to limit the time safe pinched MPD 15-20 minutes.
One of the main causes of adverse postoperative period when clamped MPD is encountered when carrying out this technique ischemic liver damage. The basis of this damage is the reduction of the level of energy metabolism in the ischemic liver tissue, respectively, the improvement of energy products in the liver cells reduces the degree of liver damage. Key moments in the onset and progression of disorders during ischemia and reperfusion of the liver tissue are hypoxia, activation of lipid peroxidation (LPO) (stimulation of free radical processes),inhibition of the antioxidant system, endotoxicosis .
The above suggests that an effective method of preventing ischemic liver damage during temporary occlusion of ELVs will be the treatment having antihypoxic and antioxidant effect, reducing the activity of lipid peroxidation, significantly increasing the energy potential of cells and has a detoxifying effect. These actions, according to Savalanche, (2002) , have infusion reamberine - balanced isotonic polygon infusion solution, with the main active component of 1.5% sodium succinate (manufacturing LLC NTFP "Polysan", St. Petersburg). In the basis of the pharmacological effects of reamberine lies that succinate is an energy metabolite product of the fifth and sixth substrate reactions of the Krebs cycle. The oxidation of succinate is carried out by the enzyme succinate dehydrogenase, the activity of which does not depend on the concentration of NAD/NADH+that hypoxia promotes the synthesis of ATP when disturbed OVER-dependent cellular respiration. Conservation of energy products is the basis for the occurrence of volatile metabolic processes in the cell, which allows the fabric to resist ischemic effects. It is logical that to be most effective solution should be to bring the right near St is significant to the liver, bypassing fabric filters and creating in the liver the greatest concentration of active substance .
Closest to the proposed development is a method of applying reamberine in patients with mechanical jaundice of non-neoplastic origin . Hypertension in the bile ducts causes a lack of blood supply to the liver with the development of ischemia and hypoxia liver cells. The solution reamberine applied 400.0Hz in units of ml / day drip into a peripheral vein for 7 days after surgery for decompression of the biliary tract.
This dynamics was studied basic biochemical blood indicators of endogenous intoxication, the state of the antioxidant system. Determined that use of the drug Reamberin in mechanical jaundice and related partial liver ischemia provides detoxification, antihypoxic, anti-oxidant and cytoprotective actions.
The disadvantage of the prototype is that Reamberin is injected into a peripheral vein and enters the liver after passing through a powerful fabric filters (muscles, lungs, intestines and other), which is accompanied by the disposal of a significant part of our preparation, leading to a decrease in their income in the liver, with a corresponding reduction therapeutic hepatotropic actions.
The invention conclusion is moved in that infusion of reamberine held in the proximal part iriatai portal vein during temporary occlusion hepato-duodenal ligament. Infusion reamberine in the portal vein proximal to the site of occlusion VCP inhibits excessive activation of processes of lipid peroxidation, activates the antioxidant system has antihypoxia and membrane-stabilizing effect on liver cells.
Before the operation, during which it is assumed temporary clamping of the hepato-duodenal ligament, first a bunch of lead round nipple rubber tube, after which the free ends of the tubes pass through a wide and short rubber tube. Clamping of the hepato-duodenal ligament carry out the tension until the complete cessation of blood flow to the liver) coming out of the pipe ends curled a bunch of tubes and their fixation on the pipe surgical clip. After that kateteriziruyut one of the branches of the portal vein (usually the right gastroepiploic vein) and within the vein down the end of the catheter close to the liver. When clamped MPD internal lumen of the catheter in the portal vein within the ligament, not clamped, which allows for the infusion of reamberine in the proximal relative to the location pinched ligament area of the portal vein. Infusion of reamberine spent is during pinched ligaments and in the next 10 minutes after its removal.
To prove the effectiveness of the invention experiments were carried out in 20 anesthetized rabbits. In rabbits at 30 minutes was perikli hepato-duodenal ligament. In earlier studies performed by us  it was shown that clamping of the tie-in at this time is absolutely fatal to rabbits. In this experiment 10 rabbits during occlusion ligaments and in the next 10 minutes after removal of the occlusion was poured vnutriaortalina directly to the liver isotonic sodium chloride solution (control group animals), other 10 rabbits was poured into an experience Reamberin (experimental group of animals). The total volume transfused solutions in all experiments was the same: 35 ml/kg during occlusion ligaments and 5 ml/kg after removal of the occlusion of the binding.
Analyzed the course and outcomes of the experiments, the data of biochemical blood tests, which were taken from the femoral vein before occlusion of the hepato-duodenal ligament and 15 minutes after its removal. The total amount withdrawn in each experiment blood was approximately 20 ml. Differences between the assessed indicators were considered to be statistically significant at p<0,05.
In the control group experimental animals one animal died during occlusion ligament, another 5 minutes after removal of the occlusion ligaments, Stalin the e eight animals lived upon removal of the occlusion ligaments 40± 2.9 minutes.
In the experimental group the experimental animals showed a significant positive effect of infusion of reamberine: none of the animals of this group were not lost during occlusion ligaments, and after resolving occlusion in experimental rabbits lived an average of 11 minutes longer than in the control group (the lifespan of rabbits after eliminating occlusion ligament was 51±3.7 minutes, the difference with the control group significantly - p<0,05).
In the control group animals according to serum chemiluminescence of peripheral venous blood, determination of the content in the serum malondialdehyde and ceruloplasmin marked increase in the intensity of lipid peroxidation and the tendency to decrease of antioxidant activity (P(Imax)/∑). Especially significantly (162,5%) increased the content of serum malondialdehyde content of ceruloplasmin remained virtually unchanged.
In the experimental group of animals, the intensity of lipid peroxidation was decreased, the trend towards reduction of antioxidant activity, but the content in the serum malondialdehyde statistically remained unchanged and 15% had a higher content of ceruloplasmin (see table 1).
Changes of some indicators of activity GENDER and ceruloplasmin in the serum of rabbits in the dynamics of the experiment (M±m)
|Groups of ANIMALS||CHEMILUMINESCENCE (Crotone)||MALONIC DIALDEHYDE (Ámol/l)||CPU (mg/l)|
|In (n=10)||118,6±8,7||91,8±3,9||1193,9±for 95.3||1053,9±107,3||3,1±0,2||3,3±0,2||to 158.4±10,3||181,9±12,5|
|Note: A group of animals who were the infusion of saline; group of animals who were infusion reamberine; P(Imax) - peak luminescence; Σ - sutasoma luminescence (60 sec.); CPU - ceruloplasmin; pre - baseline; after - indicators che the ez for 15 min after removal of the occlusion MPD.|
In the control group animals at the end of the experience dramatically increased the activity of transaminases (AST 4.4 times; Alat 4.0 times) and lactate dehydrogenase - 3.3 times.
In the experimental group of animals increased in the end of the experiment the enzyme activity was much smaller: the activity of AST was increased by 2.9 times, Alat - 2.1 times, lactate dehydrogenase - 1.7 times (see table 2).
Changes in the activity of transaminases (Alt and AST) and lactate dehydrogenase (LDH) in the serum of rabbits in the dynamics of the experiment (M±m)
|Groups of ANIMALS||Alat (U/l)||AST (IU/l)||LDH (IU/l)|
|A (n=10)||65,7±9,2||AZN 264.2±15,5||48,8±7,3||215,1±16,1||612,6±82,3||2031±70|
|In (n=10)||41,7±8,5||89,3±8,5||39,5±8,7||or 115.1±37,7||550,6±35,1||939,9±146,6|
|Note: A group of animals who were the infusion of saline; the group of animals, which was conducted infusion reamberine; pre - baseline; after-figures in 15 min after removal of the occlusion CDS.|
Thus, the data of experiments convincingly demonstrate the effectiveness of the invention, its ability to improve the body's resistance to acute temporary occlusion hepato-duodenal ligament, with the most important mechanisms of this favorable effect is the inhibition of lipid peroxidation and membrane-stabilizing effect on liver cells during ischemia and reperfusion.
1. Bilenko MV Ischemic and reperfusion injury of organs (molecular mechanisms, ways of prevention and treatment). - M.: Medicine, 1989. - 368 S.: ill.
2. Kardovsky A.G. Perfusion of the liver as a method of preventing ischemic damage in the termination of the afferent blood supply: Dis.(Kida. the honey. Sciences. - Kirov, 1984. - 146 S.: ill.
3. Obolensky SV Reamberin - a new tool for infusion therapy in the practice of medicine critical States: Methodological recommendations. - SPb.: Saint-Petersburg medical Academy of postgraduate education, 2002. - 24 S.
4. Ostroverkhov G. Transumbilical therapy of inflammatory diseases of the liver and biliary tract, " Vestn. Acad. the honey. of Sciences of the USSR. - 1971. No. 9. - P.57-62.
5. Sukhorukov the VP Transfusiology the economical provision of large and extremely large liver resections: Diss. Dr. med. Sciences. - Kirov, 1990. - 451 S.: ill.
6. Topuzov EG, Kovalenko A.L., Drohomyretska H., Balashov VK Belyakova NV Applied reamberine in patients with mechanical jaundice // Attending physician. - 1999. No. 7. - S.43-46.
7. Sauvanet A., Century is of particular interest, Belghiti J. A simplified technique of ex situ hepatic surgical treatment // J. of the American College of surgeons. - 1994. - Vol.178. - P.79-81.
The way to protect the ischemic liver induced by 30-min occlusion of the hepato-duodenal ligament in the experiment in rabbits by vnutripocherngo introduction of reamberine at a dose of 35 ml/kg during the period of occlusion, and at a dose of 5 ml/kg over 10 min after removal of the occlusion.
SUBSTANCE: method involves applying traditional treatment and additionally administering 2 ml of 1% emoxipin solution electrophoresis to epigastric zone at acute stage end daily during 10 days.
EFFECT: accelerated inflammation relief and uterine mucous membrane recovery.
FIELD: medicine, veterinary science.
SUBSTANCE: it is suggested to apply indometophen known previously as a radioprotector. It has been established that application of indometophen at different terms within the first 4 d after irradiation helps to increase survival rate and affect positively the flow of reparative processes in the body at no side effects.
EFFECT: higher efficiency of therapy.
SUBSTANCE: the present innovation deals with obtaining biologically active substances of protein nature out of cereals, moreover it is necessary to isolate a stress separating protein 310 and/or protein being immunochemically similar to that as coarse and/or finely purified extract of the target product. For this purpose one should destruct cellular walls of 3-7-d-aged sprouts due to homogenization to isolate cell-free extract due to centrifuging which should be supplemented with a reagent-precipitator at the first stage under certain conditions to obtain residue followed by isolating a liquid phase which should be subjected to the second of impact with reagent-precipitator under certain conditions, then residue should be separated against a liquid phase due to centrifuging, and an obtained coarsely purified extract of target product should be separated against reagent-precipitator due to dialysis due to the impact of fine purification by gel filtration, if necessary. Moreover, one should conduct this procedure at certain temperature mode, and , if necessary, the extract of target product should be freeze dried. The suggested biologically active substance provides efficient regulation of body energy balance.
EFFECT: higher efficiency.
8 cl, 3 ex
SUBSTANCE: invention proposes use of polysorb as drug with membrane-stabilizing efficacy supplementing early known antioxidant and sorption properties of this substance.
EFFECT: enabled use of polysorb for monotherapy to treat a large number of diseases.
FIELD: organic chemistry, medicine, pharmacy.
SUBSTANCE: invention relates to biologically active compounds. Agent represents 3,6-dioxocyclohexa-1,4-diene-1,2,4,5-tetrasulfonate sodium. The new agent elicits antioxidant properties and therefore it can be used in food industry, in pharmaceutical compositions and cosmetic products. Also, the new agent elicits antiviral activity owing to it can be used as both the independent medicinal agent and in compositions with other preparations used for treatment of viral infections.
EFFECT: expanded assortment of medicinal agents and antioxidants, realization of indicated prescription.
1 tbl, 8 dwg
FIELD: medicine, obstetrics, gynecology.
SUBSTANCE: uterine cavity should be drained in the course of operation, moreover, irrigator's distal end should be withdrawn through operation wound at anterior abdominal wall, and 2 h after the end of operation uterine cavity should be washed through irrigator with 400 ml of cooled 0.06%-sodium hypochlorite solution at perfusion rate being 200 ml/h, 6 times every 12 h up to 3-4 d; after each perfusion one should introduce 1 g kanamycin directly into uterine cavity, moreover, in case of availability of bacterioid and/or anaerobic flora in uterine cavity according to the results obtained due to pre-operational antibioticogram one should add 100 ml 3%-hydrogen peroxide solution into perfusion solution. The present innovation enables to efficiently sanitize uterine cavity due to intrauterine injection of antibiotics by taking into account antibioticogram performed at all stages of operative treatment.
EFFECT: higher efficiency of prophylaxis.
1 cl, 2 ex
FIELD: medicine, pediatrics, hematology.
SUBSTANCE: the present innovation could be applied in treating surgical and oncological diseases in children during treating and preventing anemia of different etiology. One should introduce ceruloplasmin at daily single dosage ranged 50-200 mg depending upon child's age against 100-200 ml 0.9%-sodiumchloride solution intravenously by drops at the rate of 40-50 drops/min. Moreover, for preventing and/or treating posthemorrhagic anemia in case of surgical operations one should introduce ceruloplasmin during 2 d before surgical operation, intraoperationally, and for 2-10 d after operation. For preventing and/or treating anemia in case of purulent-septic diseases ceruloplasmin should be introduced during chemotherapeutic days during the whole period of the course conducted, for preventing and treating radiation anemia at the background of radiation therapy ceruloplasmin should be injected once weekly during the whole period of radiotherapy course, for preventing and treating toxic and radiation anemia at the background of chemoradiation therapy ceruloplasmin should be introduced once weekly on the day of chemotherapy during the whole course of chemoradiation treatment. The innovation enables to avoid inflows of erythrocytic mass and donor's blood along with shortened number of procedures on introduction of ceruloplasmin and 4-times decrease in the risk for the development of severe anemia in children due to matching peculiar mode for ceruloplasmin introduction.
EFFECT: higher efficiency of therapy and prophylaxis.
4 cl, 5 ex
SUBSTANCE: method involves introducing 0.06% sodium hypochlorite solution from intravaginally arranged cathode during 10-15 min every session in 5-7 days long course.
EFFECT: reduced risk of abdominal pregnancy relapses; retained reproductive function.
SUBSTANCE: method is accomplished in the following order. First, daily sanations of vagina with 0.06% sodium hypochlorite solution are fulfilled for 10 min, total number of procedures being 5. If clinical-laboratory symptoms of inflammation disappear, eubiotics are then introduced intravaginally. In case of persistence of clinical-laboratory symptoms of inflammation, dosage forms with antimicrobial agents are introduced intravaginally or introduction of the latter is combined with oral administration of antibacterial preparations followed by intravaginal introduction of eubiotics.
EFFECT: accelerated immunocorrection leading to reduced treatment course to combined effect of sodium hypochlorite, antibiotics, and eubiotics.
FIELD: medicine, infectology.
SUBSTANCE: in acute period of bacterial dysentery one should perorally introduce azitromycin once daily at the dosage of 5 mg/kg for 5 d at simultaneous introduction of 1.5%-rheamberin solution by drops at its daily dosage being 10 ml/kg, course of 1.5-2 d. The present innovation enables to overcome antibioticoresistance of dysenteric microbes at the background of keeping and restoring intestinal microflora.
EFFECT: higher efficiency of therapy.
2 ex, 2 tbl
FIELD: medicine, surgery, urology.
SUBSTANCE: method involves administration of hypochlorite sodium in the concentration 0.004% that is combined with its intra-bladder administration in the concentration 0.06% in pre-operative and post-operative periods. Invention promotes to complete sanitation of urinary ways for the shortest time after surgery of transurethral resection of prostate. Invention can be used in prophylaxis of suppurative-inflammatory complications in patients with benign prostate hyperplasia in post-operative period.
EFFECT: improved method for prophylaxis.
FIELD: medicine, surgery.
SUBSTANCE: about 2-3 min before applying a dilator for paravertebral muscles one should treat the area of desired compression by capturing not less than 1.5 cm against the borders of dilator's place with the flow of 0.9%-NaCl solution saturated with ozone up to concentration of 400-500 mcg/l, cooled up to 18-20 C; in the course of operation every 40 min of compression one should weaken the dilator's tension for 5 min for the half against the initial value to repeat muscular treatment with high-pressure flow of 0.9%-NaCl solution saturated with ozone up to 500 mcg/l and cooled up to 18-20 C, and after removing the hernia and a dilator one should introduce normothermal 0.9%-NaCl solution at ozone concentration being about 200-300 mcg/l into paravertebral muscles at 1-2 ml ozone/2-4 cu. cm muscular mass with a blunt-end needle for the depth of either one half or one third against muscular mass. The present innovation enables to decrease intraoperational trauma of paravertebral muscles and decrease chronic infection due to antihypoxic and bactericidal properties of ozone, correspondingly.
EFFECT: higher efficiency of myoprotection.
FIELD: medicine, narcology.
SUBSTANCE: method involves alternating comatose therapy and electroshock therapy every other day. In day carrying out the comatose therapy eserine ointment is placed in conjunctival sacs to patient and in 30 min 2-2.5 mg scopolamine hydrobromide solution is administrated as its 0.5% solution. Then in 3-5 h of comatose state patient is recovered from coma and 15-30 mg of physostigmine, 6 g of pyracetam, 7.5 g of magnesium sulfate and 400 ml of sodium hypochlorite are administrated by intravenous drops. In each next séance of comatose therapy dose of scopolamine hydrobromide is increased by 0.5 mg and brought about to 5-6 mg. In day carrying out electroshock therapy 1 ml of 0.1% solution of atropine sulfate and 2 ml of cordiamine are administrated and preliminary narcosis is carried out by intravenous administration of 200-300 mg of sodium thiopental or 100 mg of ketamine with simultaneous administration of 3-4 ml 2% ditiline solution and electroshock therapy is carried out followed by artificial lungs ventilation. Method provides enhancing effectiveness of treatment and to prolong the remission period.
EFFECT: enhanced effectiveness of treatment.
FIELD: applied immunology.
SUBSTANCE: composition contains, wt parts: borax decahydrate1-25, sodium thiosulfate pentahydrate 10-5-10-4, potassium carbonate 30-150, refined sugar 30-200, and water 100-200 per 100 wt parts of sodium metasilicate pentahydrate. In addition to its capability of improving resistance to diseases, body weight increase, productivity of agricultural plants, quality of crop, and ripening term (harvest time), composition according to invention possesses nonspecific immunostimulating activity, including production of antibodies and enhancement of immunity through activation of immunocytes thereby maximally strengthening vaccination effect regarding diseases caused by malignant neoplasm viruses.
EFFECT: increased assortment of immunostimulating agents.
10 cl, 11 dwg, 12 ex
SUBSTANCE: patient rinses his/her oral cavity with 10-12% sodium chloride solution at 25-40°C for 20-25 min, after which, 10-15 min later, denture is placed into oral cavity.
EFFECT: achieved prolonged reduction in emitting reflex activity.
FIELD: organic chemistry, medicine, pharmacy.
SUBSTANCE: invention relates to derivatives of pentadicarboxylic acid of the general formula (I): or to their acceptable salts and solvates wherein X represents compound of the formula: wherein Z represents -SH; R8 means -(CH2)2COOH; A means -CR17R18-; R9 means hydrogen atom; R10, R11, R17 and R18 mean hydrogen atom, unsubstituted or substituted (C1-C9)-alkyl. Also, invention describes a pharmaceutical composition based on the claimed compounds. Compounds are designated for inhibition of enzymatic activity of enzyme NAALADase that provides the possibility for treatment of such diseases as ischemia, insult and schizophrenia by using these compounds.
EFFECT: valuable medicinal properties of compounds, improved treatment of diseases.
10 cl, 26 dwg, 7 tbl, 14 ex