Method for detecting vaginal microflora and method for treating diseases accompanied with vaginal microflora disorders

FIELD: medicine, gynecology.

SUBSTANCE: one should detect both quantitative and qualitative composition of short-chain fatty acids (SCFA) in vaginal content. Total SCFA quantity at the level of about 0.08-0.16 mg/g at the content of acetic acid being at the level of 69-83%, propionic acid at the level of 10-18% and butyric acid at the level of 7.0-13.0% in the profile of acetic, propionic and butyric acid, the content of SCFA isomers at the level of 9.9-14.9% against total level of acidic content demonstrates normal state of vaginal microflora. According to alterations of quantitative and qualitative content of SCFA against the norm one should detect the nature of vaginal microflora alteration. Based upon the data obtained applied for treating diseases accompanied with vaginal microflora disorders it is necessary to choose antibacterial preparations and/or probiotics. The method enables to increase accuracy of verification of anaerobic-aerobic populations of microorganisms that provides opportunity for matching the most efficient therapeutic scheme.

EFFECT: higher efficiency of detection.

11 cl, 3 ex

 

The invention relates to medicine, in particular to the gynecologist, and can be used for the diagnosis of bacterial vaginosis, with the purpose of definition and identification of microflora in the vaginal contents for the selection of individual therapy with the received data.

Inflammatory diseases of female genital organs are an important medical and social problem: the frequency, severity and duration caused by disorders - menstrual, sexual and generative functions, as well as the nervous, vascular and endocrine systems - this disease is one of the first places (Kira E.F. Bacterial vaginosis // Akush. and gin. - 1990. No. 8. - P.10-11.; Savelyeva G.M., Antonova L.V. Acute inflammatory diseases of uterine appendages // Akush. and gin. 1992. No. 3. - P.52-54). One of the most common inflammatory diseases among women of reproductive age is bacterial vaginosis - a violation of vaginal microecology. Vaginal microflora, representing a dynamic microecosystem, plays an extremely important role in maintaining women's health at an optimal level. Impact on a woman's body various factors exogenous or endogenous nature can lead to violations of the microflora and the development of dysbacteriosis of a vagina. To predisposing fact the frames, leading to the development of bacterial vaginosis, can be attributed to the use of antibiotics, sometimes uncontrolled, prolonged use of intrauterine contraceptive devices, previous or concomitant inflammatory diseases of the genital organs, the menstrual function, changing the state of local immunity, the effect of small doses of ionizing radiation, stress effects on the body. 60% of women suffering from bacterial vaginosis, reveals a dysbacteriosis of the intestine, suggesting the presence of dysbiotic process in the body with a pronounced manifestation of his or reproductive or digestive system (Not, Vmichael Overow. Bacterial vaginosis. Methodical recommendations. M. 2000. P.12-48).

Currently, for the diagnosis of bacterial vaginosis methods are used, Podkopayeva simplicity, availability, and speed of execution. Including tests screening diagnostics proposed by R. Amsel et al. (1983) and based on a set of 4 diagnostic criteria, including abnormal vaginal discharge; changes in pH of vaginal discharge more than 4.5; positive amine test; identification of "key" cells microscopic examination of wet unstained preparations of vaginal discharge. These criteria are named is iterature "diagnostic gold standard". However, the main disadvantages of this method are: the lack of specificity studies of conditionally pathogenic microorganisms represented by the populations of the indigenous microflora, no possibility to select individual patients taking into account the above data, the use of expensive test strips and mn. other in Addition, only one of the four tests is insufficient for diagnosis, therefore diagnostically significant, you should assume the existence of three positive signs of four (Prilepskaya V.N., Ancyra A.S., Bayramova BORN in Bacterial vaginosis M., 1998, p.41-49).

Wide application currently has a bacteriological study of the vaginal flora (Agaves, Glowlink, Aaaaaarg, Manual of medical Microbiology. Translation from English under the editorship of Dr. SC Twierdza. Moscow: Medicine, 1982, volume 2, Chapter 26, str-292. Manual for doctors. Kudryavtseva L.V., Rollin E., Govorun V.M., V. Minaev and other Bacterial vaginosis // Institute of physico-chemical medicine, Ministry of health of the Russian Scientific-production firm "Licej", Moscow state University. University, Ramapo. Moscow, 2001, 38 C.). However, diagnosis of dysbiotic conditions causes significant difficulties. This is due to the selection of only certain types of microorganisms from a wide range of populations of microflora moisture is Lisa, difficulty anaerobic cultivation, availability of expensive culture media, a large number of "false positive" and "false negative" results, lasting results, making it impossible to use this method in screening diagnosis and evaluation of treatment (Chow et al., Vaginal microbial flora in normal young women / Brit Med 1986 1450-1453; Fohn et al., Cervical and vaginal bacterial flora / Am J Obstet Gynecol. 1988, 130, 658-661; Ceddia et al., 1989; Amer J Obstet GynecoL, 1993, 42-43).

The closest in technical essence and the closest analogue of the invention is the determination of short-chain fatty acids in the vaginal contents (Ed. Kudryavtseva L.V., Rollin E., Govorun V.M., V. Minaev and other Bacterial vaginosis. Manual for doctors. // The research Institute of physical-chemical medicine, Ministry of health of the Russian Scientific-production firm "Licej", Moscow state University. University, Ramapo. Moscow, 2001, 38 S.).

However, the data presented only to illustrate the possibility of using short-chain fatty acids for the diagnosis of bacterial vaginosis. Currently we do not find in the literature of normative content values CZK in the vaginal contents; and no established correlation parameter changes KIK and changes in the microflora established by bacteriological examination, makes this study not essential for the practice of medicine, because it is not adapted the AET for the determination of the species composition of the microflora of the vagina and may not be applied for the selection of individual treatment, accompanied by disturbances of the vaginal flora.

The present invention is to provide a method of diagnosing bacterial vaginosis is often encountered in gynecologic practice, and based on it the treatment of diseases involving disorders of the vaginal flora, with high accuracy verification anaerobic-aerobic microorganism populations with a significant reduction in time to produce results; as well as giving an opportunity to assess the necessity of pharmacological preparations, to determine the range of their actions and to assess the effectiveness of the treatment in real time at low cost research.

The method is based on determining the quantitative and qualitative composition of short-chain fatty acids, which are metabolites of anaerobic and aerobic populations of the indigenous microflora. To short-chain fatty acids (fraction C2-C6) include acetic, propionic, isomaltol, oil, isovalerianic, Valerian, isocaproate and Caproic acid. The result that can be achieved with the implementation of the method is high accuracy verification anaerobic and aerobic microorganism populations of a small number of the studied material in the rapidity of response (25 min), which leads to the WWTP is temporary and evidentiary purpose pharmacological agents and to evaluate the effectiveness of the treatment in real time, given the low cost of research.

In our work studies were performed in 40 healthy women and in 60 patients with various gynecologic pathology involving bacterial vaginosis.

The invention is based on the identified logical fact, namely, that the detection in the vaginal content of the total quantity of short-chain fatty acids at the level of 0.08-0.16 mg/g indicates normal microflora of the vagina. Decrease or increase the total amount of short-chain fatty acids indicates the change in the number and functional activity of obligate and opportunistic microflora of the vagina. Verification of species composition of the microflora of the vagina is on the qualitative content of short-chain fatty acids, i.e. for the percentage of individual acids. The content of acetic acid on the level 69-83%, propionic acid at the level of 10-18% and butyric acid - level 7-13% in the pool of acetic, propionic and butyric acids, the content of short-chain isomers of fatty acids at the level of 9.9-14.9% of the total content of acids indicate normal microflora of the vagina.

The increase in propionic and butyric acids in the qualitative composition of short-chain fatty acids svidetelstvo what about the increased amounts in the vagina anaerobic microorganism populations and reducing obligate populations of bifidobacteria and lactobacilli. According to our data, when the content of propionic acid on the level of 22.0-39.0 per cent and acetic acid at the level of 55-65% of the increase in the number of bacteria of the genera Bacteroides, Veillonell, Propionibacterium vagina; when the content of butyric acid on the level 22-41%, acetic acid at the level of 46-65% and propionic acid at the level of 7-15% of bacteria of the genus Clostridium and Fusobacterium; the content of propionic acid at the level of 20-31%, butyric acid at the level of 15-25% and acetic acid at the level of 47-60% indicates an increase in the vagina mixed anaerobic flora. The content of propionic acid at the level of 21-29%, butyric acid at the level of 17-32% and isocyclic level of 16.2-18.4 per cent indicates an increase in the vagina anaerobic flora with proteolytic and hemolytic activity.

The increase in the percentage of acetic acid and isomers short-chain fatty acids in the qualitative composition of short-chain fatty acids indicating a higher number in the vagina aerobic microorganism populations and reducing obligate populations of bifidobacteria and lactobacilli. The content of acetic acid at the level of 85-93%, propionic acid at the level of 4.0 to 10.0%, butyric acid at 3.0 to 5.0% indicates an increase of microorganisms of the genera E. coli, aerobic streptococci and staphylococci; the content of acetic acid at the level of 87-93% and isomers cor is diaochan fatty acids at 18.5-25.4 per cent indicates an increase in the vagina aerobic microorganism populations having proteolytic activity. Change the content of acids in the range of 1-2% of the normal indicators shows minimal changes to the microflora of the vagina.

The choice of antibacterial agents is carried out according to the data of the changes in the content of short-chain fatty acids, indicating the nature of the violations of species composition and population abundance of microorganisms. In the case of minimal changes from short-chain fatty acids antibacterial drugs are not assigned, you can use other tools such as pre - and probiotics.

On the background of effective therapy is to change the content of short-chain fatty acids in the vagina towards normal values.

The method is as follows.

The patient during examination (using mirrors) is vaginal wash 3,0-I ml of sterile distilled water in a sterile tube. Explore the quantitative content and qualitative composition of short-chain fatty acids in the received content. The results of the study conclude that the nature of microbial populations in the vagina (as mentioned above). In the case of change detection is assigned to a particular drug according to the obtained data. After a course of therapy, a repeat study in againoh content to assess the effectiveness of the treatment.

Below are examples of violations of the microflora of the vagina and treatment of diseases involving data breaches, confirming the possibility of using this method, which is not limited to them.

Example 1.

Patient L., aged 34. Diagnosis: Acute adnexitis. Bacterial vaginosis. Admitted with complaints: on discharge from the genital tract, itching, burning in the vagina.

From the anamnesis it is known: considers herself a patient since March 2002, when there was a discharge from the genital tract after coitus, with the smell. This deterioration may 2002, when the above complaints were joined by itching and burning in the vagina. At entry: Skin and visible mucous regular color. In the lungs vesicular breathing, wheezing no. Respiratory rate 16 per minute Cor tones - clear rhythmic noises. HR 84 minutes, the Abdomen is soft, painless. Physiological functions are normal. Gynecological status: External genitals are developed correctly. Adult female type. Examination with the help of mirrors: the cervix is cylindrical in shape, clean. Selection slimy, rich with the smell. Bimanual vaginal-abdominal examination: the body of the uterus is normal in size, firm, mobile, painless. Appendages on both sides are not defined, their painless on palpation. The vaults are free.

PR is conducted tests: complete blood count - erythrocytes 3.9 million, hemoglobin 119 g/l, leukocytes 6.9 thousand, platelets 125, lymphocytes 35% in 1 mm, ESR 11 mm/h Total urine analysis showed no pathology. Biochemical study: sugar 4.5 mmol/l, cholesterol 3.3 mmol/l, total protein 76,0 g/l, total bilirubin of 23.4 μmol/l, direct bilirubin 5.1 µmol/l, ALT 34 u/l ACT 33,5 u/l, alkaline phosphatase 245 U/l

Ultrasound pelvis uterus size 32/49/47 structure is non-homogeneous M-echo mm Right ovary 27/31 with multiple follicles, right fallopian tube b/O. Left ovary 25/35 b/O. Smears on flora: the Epithelium lot, leukocytes 2-3 in p/C, coccal flora, found a large number of "key cells" PCR diagnostics detected Gardnerella vaginalis.

Bacteriological examination of vaginal contents revealed the presence of E. coli with altered properties, increased number of aerobic strepto - and staphylococci, reducing the number of obligate microorganisms of the genera Bifidobacterium and Lactobacillus.

In the study of the vaginal contents on the contents of short-chain fatty acids were identified following changes: the percentage of total short-chain fatty acids amounted to 0.03 mg/g, which indicates the change in the number and functional activity of microflora. In the pool of acetic, propionic and butyric acids content of acetic acid was the 89%, propionic acid - 7,1%, butyric acid was 3.9%, which indicates the presence of a vagina microorganisms of the genera E. coli, aerobic streptococci and staphylococci, the reduction of the number of obligate microorganisms of the genera Bifidobacterium and Lactobacillus.

To treatment added ampicillin 500 mg 4 times a day intramuscularly for 7 days and probiotic that contains live cultures of bifidobacteria and lactobacilli ("Biovestin Lacto" 3 ml intrawaginalno).

therapy has improved the General condition of the patient, relief of itching and burning, reduction of vaginal discharge, changes in their nature.

During the control study of vaginal contents after treatment in the bacteriological analysis showed a positive trend: bacteria of the genus E. coli with altered properties not found, reduced the number of aerobic strepto - and staphylococci, increased the number of obligate microorganisms of the genera Bifidobacterium and Lactobacillus.

In the study Karakocan fatty acids after treatment had elevated levels of short-chain fatty acids to 0.12 mg/g and changes in qualitative composition of short-chain fatty acids: the percentage of acetic acid was 82%, propionic acid 11%, butyric acid - 7.0% and isomers of the acid - 11,1%, which confirms the effectiveness conducted by the military antibiotic and probiotic therapy.

Example 2.

Patient S., aged 35. Diagnosis: Exacerbation of chronic oophoritis, bacterial vaginosis.

Admitted with complaints: excessive discharge from the genital tract, itching. From the anamnesis it is known: considers himself sick about 4 years. Repeatedly held antibiotic treatment with a short-term effect. This deterioration in about a week, when appeared the above complaints, and therefore turned to the doctor. At entry: Skin and visible mucous regular color. In the lungs vesicular breathing, wheezing no. Respiratory rate 16 per minute Cor tones - clear rhythmic noises. HR 84 minutes, the Abdomen is soft, painless. Physiological functions are normal. Gynecological status: External genitals are developed correctly. Adult female type. Examination with the help of mirrors: the cervix is cylindrical in shape, clean. Selection slimy, rich with the smell. Bimanual vaginal-abdominal examination: the body of the uterus is normal in size, firm, mobile, painless. Appendages on both sides are not defined, areas sensitive to palpation. The codes free. The survey: the General analysis of blood - erythrocytes 3.9 million, hemoglobin 110 g/l, leukocytes 5,9 thousand, platelets 125, lymphocytes 35% in 1 mm, ESR 17 mm/h Total urine analysis showed no pathology. Biochemical study: Sahar,5 mmol/l, cholesterol 3.3 mmol/l, total protein 61,0 g/l, total bilirubin of 20.4 µmol/l, direct bilirubin 5.1 µmol/l, ALT 42 u/l ACT 39,5 u/l, alkaline phosphatase 245 U/l Ultrasound pelvis: uterus size 32/47/39 structure is non-homogeneous M-echo 1 mm Right ovary 26/31 with multiple follicles, the right fallopian tube is slightly swollen. The left ovary 25/35 b/O.

Smears on flora Epithelium lot, leucocytes 2-Star s/C, mixed flora, found a large number of "key cells". PCR diagnosis: detected Gardnerella vaginalis.

Bacteriological examination of vaginal contents revealed the presence of mixed anaerobic flora (bacteria of the genera Bacteroides, Clostridium and Fusobacterium).

In the study of the vaginal contents on the contents of short-chain fatty acids were identified following changes: the percentage of total short-chain fatty acids was 0.19 mg/g, which indicates the change in the number and functional activity of microflora. In the pool of acetic, propionic and butyric acids content of acetic acid was 52%, propionic acid, 27%, butyric acid and 21%, indicating the presence of the vagina mixed anaerobic flora (bacteria of the genera Bacteroides, Clostridium and Fusobacterium).

To treatment, including metronidazole 500 mg 2 R in day of 7 days, local treatment: cream Metrogylum II andstc is vaginally 5 days.

therapy has improved the General condition of the patient, no complaints, allocation decreased and normalized their character.

During the control study of vaginal contents after treatment in the bacteriological analysis showed a positive trend: a decrease in the number of mixed anaerobic flora (bacteria of the genera Bacteroides, Clostridium and Fusobacterium).

In the study of short-chain fatty acids after treatment had elevated levels of short-chain fatty acids to 0.14 mg/g and changes in qualitative composition of short-chain fatty acids: the percentage of acetic acid was 79%, propionic acid - 12%, butyric acid, and 9.0% and isomers of the acids is 12.2%, which confirms the efficacy of antibiotic therapy.

Example 3.

Patient M., 28 years old Diagnosis: Infertility 2. Bacterial vaginosis. Admitted with complaints: in the absence of pregnancy. From the anamnesis it is known: considers herself a patient 3 years, periodically treated. At entry: skin and visible mucous regular color. In the lungs vesicular breathing, wheezing no. Respiratory rate 16 per minute Cor tones - clear rhythmic noises. HR 84 minutes, the Abdomen is soft, painless. Physiological functions are normal. Gynecological status: External genitals are developed correctly. Pilosis on W is Nkomo type. Examination with the help of mirrors: the cervix is cylindrical in shape, clean. The mucous allocation, moderate. Bimanual vaginal-abdominal examination: the body of the uterus is normal in size, firm, mobile, painless. Appendages on both sides are not defined, their painless. The vaults are free.

The survey: the General analysis of blood - erythrocytes 3.7 million, hemoglobin 121 g/l, leukocytes 6.5 thousand, platelets 125, lymphocytes 35% in 1 mm, ESR 10 mm/h Total urine analysis showed no pathology. Biochemical study: sugar 4.5 mmol/l, cholesterol 3.3 mmol/l, total protein 71,0 g/l, total bilirubin of 16.4 µmol/l, direct bilirubin 3.1 µmol/l, ALT 32 u/l ACT OF 29.5 U/L. a

Ultrasound pelvis uterus size 38/47/59 structure is non-homogeneous M-echo 5 mm Right ovary 36/31 with multiple follicles, right fallopian tube b/O. Left ovary 35/42 b/O.

Smears on flora Epithelium lot, leukocytes 7-8V p/C, flora rod, obnarujenno a small number of "key cells" PCR diagnostics detected Gardnerella vaginalis.

Bacteriological examination of vaginal contents revealed a decrease in the number of obligate microorganisms of the genera bifidobacteria and lactobacilli, with a slight increase facultative aerobes.

In the study of the vaginal contents on the contents of short-chain W the situations acids were identified following changes: the percentage of total short-chain fatty acids was 0.07 mg/g, which indicates that minor changes in the number and functional activity of microflora. In the pool of acetic, propionic and butyric acids content of acetic acid was 84%, propionic acid and 9.3%, butyric acid and 6.7%, indicating a minor imbalance in anaerobic-aerobic microorganism populations.

To treatment hormonal means about the main pathology of the added probiotic oral Biovestin-lacto 3 ml 2 R in day. 10 days and intrawaginalno - tampons with Biovestin lacto 3 ml 4 days.

The reliability of the method was confirmed by comparison with traditional bacteriological examination. The sensitivity of the method 94±2%. Specificity 92±2%. Reproducibility 96±2%.

Thus, the proposed method for the diagnosis of vaginal microflora and based on the method of treatment of diseases involving disorders of the microflora of the vagina, allows to achieve high accuracy verification anaerobic and aerobic microorganism populations of a small number of the studied material in the rapidity of response (25 min), which leads to timely and evidence-based appointment pharmacological agents and to evaluate the effectiveness of the treatment in real time at a low cost of exploration is.

1. The method of determining violations of the vaginal flora, which includes a study of vaginal contents, characterized in that it determines the quantitative and qualitative content of short-chain fatty acids, the total amount of short-chain fatty acids at the level of 0.08-0.16 mg/g when the content of acetic acid on the level 69-83%, propionic acid at the level of 10-18% and butyric acid at the level of 7.0-13.0% in the profile acetic, propionic and butyric acids, the content of short-chain isomers of fatty acids at the level of 9.9-14.9% of the total content of acids indicates normal microflora of the vagina, and the reduction or increase the total amount of short-chain fatty acids or their percentage indicates the change in activity of obligate and opportunistic microflora of the vagina.

2. The method according to claim 1, characterized in that the increase in propionic and butyric acids in the qualitative composition of short-chain fatty acids indicating a higher content of the vagina anaerobic microorganism populations and reducing obligate populations of bifidobacteria and lactobacilli.

3. The method according to claim 1, characterized in that the content of propionic acid on the level of 22.0-39.0 per cent and acetic acid at the level of 55-65% indicates increased and the number of bacteria of the genera Bacteroides, Veillonell, Propionibacterium vagina.

4. The method according to claim 1, characterized in that the content of butyric acid on the level 22-41%, acetic acid at the level of 46-65% and propionic acid at the level of 7-15% indicates an increase in the number of bacteria of the genera Clostridium and Fusobacterium the vagina.

5. The method according to claim 1, characterized in that the content of propionic acid at the level of 20-31%, butyric acid at the level of 15-25% and acetic acid at the level of 47-60% indicates an increase in the vagina mixed anaerobic flora.

6. The method according to claim 1, characterized in that the content of propionic acid at the level of 21-29%, butyric acid at the level of 17-32% and isocyclic level of 16.2-18.4 per cent indicates an increase in the vagina anaerobic flora with proteolytic and hemolytic activity.

7. The method according to claim 1, characterized in that the increase in the percentage of acetic acid and isomers short-chain fatty acids indicates that an increasing number of aerobic microflora and reducing the number of obligate populations of bifidobacteria and lactobacilli in the vagina.

8. The method according to claim 1, characterized in that the content of acetic acid at the level of 85-93%, propionic acid at the level of 4.0 to 10.0%, butyric acid at 3.0 to 5.0% indicates the presence of microorganisms of the genera E. coli, aerobic streptococci and staphylococci in the vagina.

9. The way is about to claim 1, characterized in that the content of acetic acid at the level of 87-93% and isomers short-chain fatty acids at 18.5-25.4 per cent indicates an increase in the vagina aerobic microorganism populations possessing proteolytic activity.

10. A method of treatment of diseases involving disorders of the microflora of the vagina, characterized in that the content in the vaginal investigate the concentration and quality of the short-chain fatty acids in accordance with claims 1 to 9, while choosing antibiotics and/or probiotics in accordance with changes in the microflora set on changing the qualitative and quantitative composition of short-chain fatty acids.

11. The method according to claim 10, characterized in that the treatment process control its performance on the quantitative and qualitative composition of short-chain fatty acids.



 

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1 tbl

FIELD: medicine, hepatology.

SUBSTANCE: one should detect the level of hepato-specific enzymes (HSE) in blood plasma, such as: urokinase (UK), histidase (HIS), fructose-1-phosphataldolase (F-1-P), serine dehydratase (L-SD), threonine dehydratase (L-TD) and products of lipid peroxidation (LP), such as: dienic conjugates (DC), malonic dialdehyde (MDA). Moreover, one should detect the state of inspecific immunity parameters, such as: immunoregulatory index (IRI) as the ratio of T-helpers and T-suppressors, circulating immune complexes (CIC). Additionally, one should evaluate the state of regional circulation by applying rheohepatography (RHG), the system of microhemocirculation with the help of conjunctival biomicroscopy (CB) to detect intravascular index (II). In case of increased UK, HIS levels up to 0.5 mcM/ml/h, F-1-P, L-SD, L-Td, LP products, CIC by 1.5 times, higher IRI up to 2 at the norm being 1.0-1.5, altered values of regional circulation, increased II up to 2 points at the norm being 1 point, not more one should diagnose light degree of process flow. At increased level of UK, HIS up to 0.75 mcM/ml/h, F-1-P, L-SD, L-TD, LP products, CIC by 1.5-2 times, increased IRI up to 2.5, altered values of regional circulation, increased II up to 3-4 points one should diagnose average degree of process flow. At increased level of UK, HIS being above 0.75 mcM/ml/h, F-1-P, L-SD, L-TD, LP products, CIC by 2 and more times, increased IRI being above 2.5, altered values of regional circulation, increased II up to 5 points and more one should diagnose severe degree of process flow.

EFFECT: higher accuracy of diagnostics.

3 ex

FIELD: medicine, infectology, hepatology.

SUBSTANCE: in hepatic bioptate one should detect products of lipid peroxidation (LP), such as: dienic conjugates (DC), activity of antioxidant enzymes, such as: catalase (CAT)and superoxide dismutase (SOD). One should calculate by the following formula: C = DC/(SOD x CAT)x100, where DC - the content of dienic conjugates, SOD - activity of superoxide dismutase, CAT - activity of catalase. At coefficient (C) values being above 65 one should predict high possibility for appearance of cirrhosis, at 46-645 - moderate possibility and at 14-45 -low possibility for appearance of cirrhosis.

EFFECT: higher accuracy of prediction.

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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