Method for rehabilitation of infantile cerebral paralysis (icp) disabled children with infection background

FIELD: medicine.

SUBSTANCE: invention relates to medicine and pediatrics. The method consists of clinical examination of a child and carrying out of therapeutic procedures. There are determined abnormalities in immunologic state of main cell markers: total leukocyte count, lymphocytes CD3, CD4, CD4/CD8, CD19, classes A, M, G of antibodies levels; antibodies to chlamydia, HSV (herpes simplex virus), CMV (cytomegalovirus), toxoplasma, toxocaria, lamblia, opisthorchis. Drug dosage regimen for children under four years is as follows: polyoxidonium intranasal by 5 drops 30 minutes before meal once a day for 2 days, then 2 days break, the course total duration is 20 days; administration of succinic acid by 25 mg after meal in the morning and at noon for 5 days, then 2 days break. Children four to seven years proposed to take bronchomunal P by 3.5 mg before meal every morning for 1 month; succinic acid by 50 mg twice a day as above; and ribomunil by 75 mg before meal in the morning, during first month on 4 first days of each week, and during 2nd to 6th months on 4 first days of each month. Regimen for children seven to eleven years is as follows: cyclopheron 12.5% by 2 ml once a day on 1st, 2nd, 3rd, 4th, 6th, 8th, 11th, 14th, 17th, 21st, and 25th day, then once a week for 2 months; methyluracil by 50 mg after meal three times a day for 1 month; cod-liver oil with garlic by 1 dragee after meal three times a day for 10 days; and succinic acid by 75 mg twice a day as above. Regimen for children eleven to sixteen years is as follows: timaline by 0.01 g intramuscularly by 2 ml for 20 days; cod-liver oil with garlic by 2 dragee after meal three times a day for 10 days; biologically active additive "Karvipar" by 1 dessert-spoon three times a day for 2 weeks; and succinic acid by 100 mg twice a day as above. Immune state correction course is carried out in late autumn and in early spring, in other time polyvitamins are administered every month.

EFFECT: providing of health state stabilisation in ICP children, reducing any complications.

1 tbl, 4 ex

 

The invention relates to medicine, namely Pediatrics, and can be used for the rehabilitation of children with cerebral palsy in the face of infectious process

Known methods of rehabilitation of children with disabilities are in the appointment of symptomatic treatment.

Closest to the present invention is a method of rehabilitation of children with cerebral palsy, which in the diagnosis and subsequent therapeutic interventions: massage, exercise therapy, magnetic and laser treatment, orthopedic and hydrotherapy, medicinal drugs: antibiotiki, vitamins, herbal drugs, su-Jok and acupuncture (1). However, to fully implement an accurate diagnosis is not always possible due to the severity of the manifestations of the underlying disease due to the presence of a coarse delay of psychomotor development in some forms of cerebral palsy, the combination with epileptic disease. Known methods of assessing the severity of the condition of children with disabilities are to survey parents, clinical research, clinical examination, analysis of outpatient charts of children with disabilities. The aim of the neurological examination, in addition to the normal neurological status is the assessment of violations of the static, locomotion, voluntary movements of the hands, the intensity of abnormal muscle synergy in the muscles of the shoulder of the CSOs and pelvic girdles features of muscle tone, shape these synergies, the nature and intensity of complicating their hyperkinesia, ataxia, if they occurred. Produced and assessment of the severity and characteristics of dysarthria, if the latter is detected in the patient. Established the presence of active pathological reflexes or their residual effect on the muscles of the trunk, extremities, articulatory muscles. At orthopedic examination is assessed contractures in joints of the limbs (functional or organic), their intensity, their importance in the pathology of a particular movement, dislocations or subluxations in the hip and ankle joints. Psychological tests that can be conducted not only a psychologist, but a neurologist, has the purpose to identify the presence or absence of the installation of the patient for further treatment as it pertains to the lack of effectiveness conducted earlier rehabilitation. Should identify the emotions of the patient, his ability to achieve the desired results, his reaction to the temporary successes and failures, motivation for treatment and social adaptation. Important to evaluate the overall condition of the patient, the condition of the cardiovascular system, especially blood pressure. Heart rate, breathing rate. Must be carried out OC the NSV of the gastrointestinal tract. However, the known method of rehabilitation is not effective enough in terms of its application from a disabled child with cerebral palsy in combination with the infectious process, as before prescribing the treatment does not assess the contribution of infectious process, there are no clinical and laboratory criteria level of health for children with disabilities, and therefore the treatment is given without taking into account these data, which reduces its effectiveness.

A new technical challenge is to improve efficiency by reducing the number of complications.

The task decide a new way of rehabilitation of children with cerebral palsy in the face of infectious process that involves a clinical examination of the child and the conduct of subsequent remedial measures, and additionally assess the immunological status, which determine the basic cell markers: absolute leukocyte, lymphocyte CD3, CD4, CD8, CD4/CD8, CD19, and the level of antibody classes a, M, G, antibodies to chlamydia, HSV, CMV, Toxoplasma, Toxocara, Giardia, opisthorchis and if deviations in the parameters, indicating disturbances in the immune system for children preduschelnogo age, prescribe treatment according to the scheme - polyoxidonium 5 drops on the mucous membrane of the nasal passages once a day 30 minutes before meals for two days, with a break of two days, a course of 20 days, including p is rarely, welcome succinic acid 25 mg 2 times a day morning and in the afternoon after eating according to the scheme: 5 days receive a 2 day break for preschool period prescribed for administration of broncho-munal P 3.5 mg 1 time per day in the morning on an empty stomach for 1 month, the reception of succinic acid 50 mg 2 times under the above scheme, ribomunil 75 mg 1 every morning on an empty stomach, and the first month - daily for the first 4 days of each week, and the next second through sixth months - the first 4 days of each month, for children younger school age shall receive cycloferon of 12.5% in 2 ml of 1 times a day according to the scheme: 1, 2, 3, 4, 6, 8, 11, 14, 17, 21, 25 day, then once a week for two months, methyluracil 50 mg 3 times a day after meals for one month, fish oil, garlic, 1 pill 3 times a day after meals for 10 days, succinic acid 75 mg 2 times a day for the above scheme for the children of senior school age were prescribed adjuvant 0.01 g intramuscularly with 2 ml within 20 days, fish oil, garlic 2 tablets 3 times a day after meals for 10 days, biologically active additive "Calliper" 1 dessert spoon 3 times a day for 2 weeks and succinic acid 100 mg 2 times a day under the above scheme, and the immunotherapy carried out 2 times a year - in late autumn and early spring, and in the intervals between immunotherapy conduct monthly fortification polyvitamine and complexes.

The method is as follows.

Make the assessment of children insipido, which conducted a survey of parents, conduct clinical research, clinical examination, analyze the patient card for children with disabilities, also determine the basic cell markers: absolute leukocyte, lymphocyte CD3, CD4, CD8, CD4/CD8, CD19, immunoglobulins A, G, M by flow cytometry, for example, using a flow titof-fluorimetry "Coulter Epics" company "Beckman Coulter" (USA), also using a serological method to determine antibody classes a, M, G using immunofluo-rescenter, immunofermentnogo analysis and reaction of complement fixation detect antibodies to chlamydia, HSV, CMV, Toxoplasma, Toxocara, Giardia, opisthorchis (figure 3). And further guided by the results of the study, taking into account age and Rostovskogo criterion appoint one of the treatment options.

Optimal was immune by age groups:

children preduschelnogo period (0-3) 3;

children of preschool age (3-6) 8;

children of primary school age (7-11) 11;

children of school age (12-18) 13.

Children preduschelnogo period - up to 3 years - received the following medication immunocorrective therapy:

1. Polyoxidonium - 1 vial of 0.003 was diluted in 1 ml of the odes for injection. Buried in the mucosa of the nasal passages 5 drops once a day 30 minutes before meals for two days, then a break of two days. The course consisted of 20 days, including breaks.

2. Succinic acid - 25 mg 2 times a day (morning, lunch) after meals under the scheme: 5 days of admission, 2 days break.

The preschool period (ages 3 to 6 years) received the following medicamental immunocorrective therapy:

1. Broncho-munal P 3.5 mg 1 time a day in the morning on an empty stomach for 1 month.

2. Succinic acid - 50 mg 2 times a day (morning, lunch) after meals under the scheme: 5 days of admission, 2 days break.

3. Ribomunyl 75 mg 1 every morning on an empty stomach. The first month - daily for the first 4 days of each week. The next 2-6 months - the first 4 days of each month.

Children of primary school age (7 to 11 years) received the following medicamental immunocorrective therapy:

1. Cycloferon 12,5% - 2 ml of 1 times a day according to the scheme: 1, 2, 3, 4, 6, 8, 11, 14, 17, 21, 25 day, then once in 2 ml a week for two months.

2. Methyluracil - 50 mg 3 times a day after meals for a month.

3. Fish oil with the garlic - 1 pill 3 times a day after meals. Course of 10 days.

4. Succinic acid 75 mg 2 times a day (morning, lunch) after meals under the scheme: 5 days of admission, 2 days break.

The older children of school age (12 to 18 years) received the following medication immunocorrective therapy:

1. Thymalin of 0.01. Keep the vial is dissolved in 1-2 ml of isotonic sodium chloride solution (until smooth), intramuscular injection of 2 ml for 20 days.

2. Fish oil with garlic - 2 pills 3 times a day after meals. Course of 10 days.

3. Biologically active additive "Calliper"containing bran, seed dill, and caraway. 1 dessert spoon 3 times daily with 100 ml of water for 10 minutes before eating. Course 2 weeks.

4. Succinic acid - 100 mg 2 times a day (morning, lunch) after meals under the scheme: 5 days of admission, 2 days break.

The immunotherapy is carried out 2 times a year (late fall, early spring), in the intervals between immunocorrection conduct monthly fortification multivitamin complexes. The main criterion for the effectiveness of the treatment was the frequency of colds.

As confirmation of the results of treatment in a Rehabilitation Center hreverse according to the proposed method, are extracts from the histories.

Example 1

Patient A. 2.5 years, was admitted to a Rehabilitation Center with the diagnosis: Diagnosis: G 82.1 cerebral palsy, spastic diplegia lower extremities; N 90-91 - sensorineural hearing loss, the disorder of articulation due to hearing loss (WIA, NRO - 1 level); G 91, 93.4 - encephalopathy, the external-internal hydrocephalus due to/from infection (current cytomegalovirus infections, chlamydia); mythicise syndrome; And 89 - intrauterine infection in the form of cytomegaloviruses infection with a primary lesion of the Central nervous system.

The child was survey the doctors (pediatrician, neurology, infectious disease specialist, physician, ophthalmologist, otolaryngologist, ophthalmologist, dermatologist, psychiatrist, endocrinologist). Treatment was administered based on clinical and instrumental data, severity of underlying and associated diagnosis.

In paraclinical data: a General analysis of the blood-eosinophilia to 12; biochemical analysis of blood - expressed changes in protein metabolism, urinalysis phosphate crystalluria, polymerasechain reaction is detected DNA of CMV IFA to respiratory chlamydia sharply positive.

Instrumental methods of examination: ultrasound of the abdominal cavity - the inflection of the gallbladder, EEG - moderate cerebral changes with dysfunction of subcortical structures.

The period of adaptation in the Center was quite complicated. The child was often sick with colds. Consequently interrupted courses of restorative therapy (physical therapy, massage, physiotherapy).

Conclusion the initial examination: Lymphocytosis absolute and relative. The high content of CD8, D9, BG3+D16+SD. Drastically reduced immunoregulatory index (0,46). Identified antibodies to toxoplasmosis, chlamydia. The child was treated according to the scheme for children preduschelnogo period (1-3). He received the following medication immunocorrective therapy:

1. Polyoxidonium - 1 USD 0.003 p is tsadilas in 1 ml of water for injection. Buried in the mucosa of the nasal passages 5 drops once a day 30 minutes before meals for two days, then a break of two days. The course consisted of 20 days, including breaks.

2. Succinic acid - 25 mg 2 times a day (morning, lunch) after meals under the scheme: 5 days of admission, 2 days break.

The child's condition is stabilized. Appeared in succession rehabilitation activities. Quickly began to see the effect from the treatment. When re immunological examination conclusion: relative lymphocytosis, but otherwise unremarkable. TAM, OAK without features.

The dynamics of the incidence of acute respiratory disease: 2004 - 7 times, 2005 4 times.

Example 2

Patient C., 5 years old, was admitted to a Rehabilitation Center with a diagnosis of:

G-81 cerebral palsy, right-sided hemiparesis; Q 21.0 - UPU, courttia aorta; F 80.82 - speech delay, combined with the delay of intellectual development and specific disorders of academic skills (residual organic lesion of the Central nervous system, motor alalia); Giperdinamicheskim syndrome; Q 63.1 - BP. pathology of kidney development (horseshoe kidney); And 74 - respiratory chlamydia; N 52.2 - complex astigmatism, N. 50.1 - divergent strabismus; J 35.1, 35.2 - hypertrophy nm, adenoiditis 2 tbsp.; N 57.8 - subatrophy the optic nerve disc in both eyes; L 20.9 - atopic dermatitis; BP. pathology of the biliary tract (the inflection point of the gall bladder); Pascoal asnie foot. Cerebral palsy, spastic tetraparesis, initial residual stage, a coarse delay speech development. Cystic arachnoiditis. Alalia. Coming strabismus. Subatrophy the optic nerve disc. The spasms. Adenoids II degree.

The child was examined by specialist doctors (pediatrician, cardiologist, neurologist, infectious disease specialist, physician, ophthalmologist, otolaryngologist, ophthalmologist, dermatologist, psychiatrist, endocrinologist). Treatment was administered based on clinical and instrumental data, severity of underlying and associated diagnosis.

In General, the analysis of blood without specifics, the General analysis of urine without features.

Instrumental methods of examination: ultrasound of the abdominal cavity - the inflection of the gallbladder, EEG cerebral changes quite pronounced. CT scan: multiple calcium, signs of internal asymmetric hydrocephalus.

The boy was often sick with colds due to high susceptibility to infections.

Were examined using flow cytofluorimetry "Coulter Epics" company "Beckman Coulter (USA). Conclusion the initial examination: Increased content of cytotoxic cells, broken immunoregulatory index in the direction of immunodeficiency. Gobeproductive immunoglobulin A, g ELISA for HSV, the respiratory chlamydia is strongly positive.

The child is to be treated under the scheme according to the proposed method for children of preschool age (3-6). He received the following medicamental immunocorrective therapy:

1. Broncho-munal P 3.5 mg 1 time a day in the morning on an empty stomach for 1 month.

2. Succinic acid - 50 mg 2 times a day (morning, lunch) after meals under the scheme: 5 days of admission, 2 days break.

3. Ribomunyl 75 mg 1 every morning on an empty stomach. The first month - daily for the first 4 days of each week. The next 2-6 months - the first 4 days of each month.

The child's condition has improved.

In immunological status a significant change. Conclusion: Stabilized data of the main cell markers. Normal immunoglobulins. Decreased the titer of antibodies to chlamydia and HSV.

The dynamics of the incidence of acute respiratory disease: 2004 - 8 times, 2005 - 3 times.

Example 3

Patient C., 8 years old, was admitted to a Rehabilitation Center with a diagnosis of:

F 72.02 - mental retardation, moderate due to previous trauma with a slightly pronounced behavioral disorders; Q 35 - congenital anomaly, cleft palate; impaired articulation, and other anatomical anomalies of the oral structures involved in speech functioning, causing systemic underdevelopment of speech severe; Q 53.1 - undescended testicle, unilateral; N 47.2 - atrophy of the optic nerve disc; growth retardation; Moderate diffuse changes in the pancreas and thyroid gland; J 35.2 - adenoids 1-2 article; flatfoot. Cyto is megalovirus infection with a primary lesion of the Central nervous system (cerebral palsy, spastic diplegia lower extremities).

The child was examined by specialist doctors (pediatrician, neurologist, infectious disease specialist, physician, ophthalmologist, otolaryngologist, ophthalmologist, dermatologist, psychiatrist, endocrinologist). Treatment was administered based on clinical and instrumental data, severity of underlying and associated diagnosis.

In paraclinical data(UAC, OAM) with no clear-cut violations. PCR diagnosis - detected DNA of cytomegalovirus.

Instrumental methods of examination: EEG - moderate cerebral changes. Computed tomography of the brain: - cystic changes in the right hemisphere. Ultrasound of abdominal organs, break the gall bladder.

The boy was often sick with colds due to high susceptibility to infections. Required assessment of the status of the immune system. Were examined using flow cytofluorimetry "Coulter Epics" company "Beckman Coulter (USA). Conclusion the initial examination: Absolute and relative lymphocytosis, disturbance index immunoregulation (CD4/CD8).

The child was treated under the scheme of children of primary school age (7-11). He received the following medicamental immunocorrective therapy:

1. Cycloferon 12,5% - 2 ml of 1 times a day according to the scheme: 1, 2, 3, 4, 6, 8, 11, 14, 17, 21, 25 day, then once a week for 2 ml in ECENA two months.

2. Methyluracil - 50 mg 3 times a day after meals for a month.

3. Fish oil with the garlic - 1 pill 3 times a day after meals. Course of 10 days.

4. Succinic acid 75 mg 2 times a day (morning, lunch) after meals under the scheme: 5 days of admission, 2 days break.

The child's condition has improved. Testing has shown efficacy in therapy. Conclusion: variant rules.

The dynamics of the incidence of acute respiratory disease: 2004 - 5 times, 2005 - not marked.

Example 4

Patient G., aged 15, he entered a Rehabilitation Center with a diagnosis of G-81 cerebral palsy, left-side hemiparesis; Q 90 - Syndrome; L 20.0 - atopic dermatitis; And 52.2 - astigmatism; F 72.04 - severe mental retardation with a slightly pronounced behavioral disorders associated with chromosomal violation; Hypertrophy n/m 2-3 tbsp. Threatening development gretillat. Kyphoscoliotic posture; 66 Items. opisthorchiasis; Ptosis 1-2 article; the Systematic underdevelopment of speech severe.

The child was examined by specialist doctors (pediatrician, neurologist, infectious disease specialist, physician, ophthalmologist, otolaryngologist, ophthalmologist, dermatologist, psychiatrist, endocrinologist). Treatment was administered based on clinical and instrumental data, severity of underlying and associated diagnosis.

In paraclinical data: OAK: marked eosinophilia, OAM without pathology, biochemical analysis of the carbohydrate (fasting glucose of 7 mmol/l), pigment metabolism (bilirubin 30-10-11).

Instrumental methods: ultrasound of the abdominal organs: diffuse changes in the liver, pancreas; CT scan: multiple calcium left hemisphere, possibly innate character.

Evaluation of the immune system. Conclusion the initial examination: there was a sharp decrease of CD19, hyperproduction of CD8 disturbed immunoregulatory index in the direction of immunodeficiency (IRI 0,64), gobeproductive immunoglobulin A, G, secretory immune deficiency. ELISA: antibody opisthorchis positive.

The child was treated according to the scheme - the children of senior school age (12-18). He received the following medicamental immunocorrective therapy:

1. Thymalin of 0.01. The contents of the vial dissolved in 1-2 ml of isotonic sodium chloride solution (until smooth), intramuscular injection of 2 ml for 20 days.

2. Fish oil with garlic - 2 pills 3 times a day after meals. Course of 10 days.

3. Succinic acid - 100 mg 2 times a day (morning, lunch) after meals under the scheme: 5 days of admission, 2 days break.

It was re-study of the immune system. Conclusion: eosinophilia, the main cell markers within the physiological norm, moderately low concentration of immunoglobulin G. the Dynamics of the opisthorchiasis not observed the axis. In biochemical analysis: improving carbohydrate and pigment metabolism. (fasting glucose 4.6 mmol/l, bilirubin 9-12-5). She became less sick with colds. The dynamics of the incidence of acute respiratory disease: 2004 - 4 times, 2005 - 1 times.

The mode of the proposed method is proposed based on the analysis of data from clinical observations of two groups of children with disabilities. The data given in the table on Immune-pathology of children with disabilities attending rehabilitation center", Class VI Diseases of the nervous system (G)).

We examined two groups of children with disabilities. The main group included 35 children with Central nervous system (cerebral palsy). They studied the immune status to held immunokorrigirujushchej and after treatment. The control group consisted of 35 children with Central nervous system (cerebral palsy). They also studied the immune status without ongoing immune. In the main group during the initial examination revealed immunodeficiency 30 children. After the course immunocorrection in 21 (60%) of the child noted the positive dynamics (normalization of leukocytes, lymphocytes, increase the basic cell markers CD3, CD4, CD8, alignment immunoregulatory index, normalization of parameters of Ig A, G, M). The effectiveness of this treatment regimen in relation to certain pathogens: chlamydia Ulu is due in 7 children from 21 (33,3%), HSV in 4 out of 11 (36,36%), CMV improvement in 4 out of 9 (44,44%).

The second group (control) consisted of outpatient children. The initial examination of the immune status immune disorders were observed in 32 children. Immunologiya therapy they were not carried out. Improved immunological parameters were observed in 6 children (18,75%). With the re-examination on a separate infections (chlamydia, HSV, CMV) expressed speakers were not. All were produced 140 research immunograms.

The effectiveness of this treatment regimen was confirmed using the methods of statistical processing (used the criteria of Pearson). The error in the analysis of the work done less than 5%, indicating that the reliability of the results.

Thus, the proposed method allows to conduct highly efficient rehabilitation of children with cerebral palsy on the background of the infectious process, thereby greatly to increase his rehabilitation potential, and if not to improve the health indicators, at least to stabilize them for a longer period.

Sources of information

1. Caselnova. Restorative treatment of patients with residual stage of cerebral palsy, "Antidoron", Moscow,1999 (prototype).

OS the ESD group of 35 children The control group of 35 childrenX2P
Before the treatmentAfter the treatmentBefore the treatmentAfter the treatment
Leukocytes9110612.70<0.002
Lymphocytes2314251849.40<0.002
CD3 (t limp.)941089.47<0.05
CD4 (t helper)126161119.10<0.002
CD8 (t SUPR.)155161123.02<0.002
CD4+/CD8+309322630.71<0.002
CD3+CD16+CD56105131215.120.002
CD 19128141311.95TNK9510910.96<0.01
Immun. And1472116At 30.670.002
Immun. G173161527.900.002
Immun. M155141019.470.002
Cl. pneum2114171533.740.0
02
Cl. trach0000--
HSV117201830.25<0.002
CMV105121113.160.002
TOKCOKAP030000 --
TOXOPLASMOSIS2211--
GIARDIASIS3255--
OPISTHORCHIASIS1122--

The method of rehabilitation of children with cerebral palsy in the face of infectious process that involves a clinical examination of the child and the conduct of subsequent remedial measures, characterized in that it further assess the immunological status, which determine the basic cell markers: absolute leukocyte, lymphocyte CD3, CD4, CD8, CD4/CD8, CD19, and the level of antibody classes a, M, G, antibodies to chlamydia, HSV, CMV, Toxoplasma, Toxocara, Giardia, opisthorchis and if deviations in the parameters, indicating disturbances in the immune system for children preduschelnogo age prescribed treatment scheme - polyoxidonium 5 drops on the mucous membrane of the nasal passages once a day 30 minutes before meals for two days, with a break of two days, a course of 20 days, including breaks, reception succinic acid 25 mg 2 times a day morning and in the afternoon after eating according to the scheme: 5 days PR is EMA, 2 day break for preschool period prescribed for administration of broncho-munal P 3.5 mg 1 time per day in the morning on an empty stomach for 1 month, the reception of succinic acid 50 mg 2 times under the above scheme, ribomunil 75 mg 1 every morning on an empty stomach, and the first month - daily for the first 4 days of each week, and the next second through sixth months - the first 4 days of each month, for children of primary school age shall receive cycloferon of 12.5% in 2 ml of 1 times a day according to the scheme: 1, 2, 3, 4, 6, 8, 11, 14, 17, 21, 25 day, then once a week for two months, methyluracil 50 mg 3 times a day after meals for one month, fish oil, garlic, 1 pill 3 times a day after meals for 10 days, succinic acid 75 mg 2 times a day under the above scheme, for children of school age were prescribed adjuvant 0.01 g intramuscularly with 2 ml within 20 days, fish oil, garlic 2 tablets 3 times a day after meals for 10 days, biologically active additive "Caviar", 1 dessert spoon 3 times a day for 2 weeks and succinic acid 100 mg 2 times a day under the above scheme, and the immunotherapy carried out 2 times a year - in late autumn and early spring, and in the intervals between immunotherapy conduct monthly fortification multivitamin complexes.



 

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4 tbl, 3 ex

FIELD: medicine, pharmaceutics.

SUBSTANCE: invention refers to pharmaceutical industry, specifically to agent of immunomodulating activity. Application of water-soluble polysaccharides made of birch leaves, as an agent of immunomodulating activity, stimulating Th1-dependent type of immune response. Water-soluble polysaccharides described above produced of birch leaves are effective immunomodulators and activators of Th1-dependent immune response.

EFFECT: development of effective method of immunomodulator production of birch leaves.

2 tbl, 1 ex

FIELD: medicine.

SUBSTANCE: invention concerns application of polypeptide FGF-9 or its biologically active fragment to produce medical product for multiple sclerosis treatment. Polypeptide can be 94-95% identical to sequence from amino acid 1 to amino acid 208 of human FGF-9, presented on fig. 3 (SEQ ID NO: 5).

EFFECT: invention stimulates myelination, proliferation and persistency of oligodendrocyte neurons, improves nervous regeneration.

6 cl, 9 dwg, 3 tbl, 3 ex

FIELD: chemistry.

SUBSTANCE: invention relates to producing the novel compounds with dipeptidyl peptidase IV (DPP-IV) inhibiting activity and particularly, it relates to the compounds with the condensed 1,3-dihydroimidazole cycle. The invention relates to the compounds represented by the common formula (II), or their pharmaceutically acceptable salts, where, Z3a means nitrogen atom or the group with formula -CR2a=; X3a means oxygen atom or sulfur atom; T1a means piperazine-1-yl group, 3-amino-piperidine-1-yl group, 3-methylamino-piperidine-1-yl group; X1a means oxygen atom hydrogen, C2-6-alkenyl group, C2-6-alkynyl group or benzyl group; each of R1a and R2a independently means hydrogen atom, halogenatom, C1-6-alkyl group, cyanogroup or group, represented with formula-A0a-A1a; A0a means oxygen atom, sulfur atom or group, represented with formula-NA2a-; Ala means hydrogen atom, C1-6-alkyl group, C1-6-alkenyl group, C2-6-alkynyl group, phenyl group, cyanophenyl group, carbamoylphenyl group, benzyl group; A2a means hydrogen atom or C1-6-alkyl group; X2a means hydrogen atom, C2-6-alkenyl group, C2-6-alkynyl group, 1H-piridine-2-onyl group, 1-methyl-1H-piridine-2-onyl group, C1-6-alkyl group, which can have a group, selected from the substitutes group specified below B, phenyl group, which can have a group, selected from the substitutes group specified below B, 5- or 6-membered heteroarylgroup, containing one or two nitrogen atoms, oxygen or sulfur, which can have a group, selected from the substitutes group specified below B, phenylC1-6-alkyl group, which can have a group, selected from the substitutes group specified below B: <Substitutes group B> substitutes group B is group, including chlorine atom, bromine atom; cyanogroup, C1-b-alkyl group, C2-b-alkenyl group, C2-6-alkynyl group, C3-8-cycloalkyl group, C1-6alcoxigroup, carbamoyl groupcarboxyl group and C1-6-alcoxicarbonyl group.

EFFECT: research and revealing compounds with DPP-IV inhibiting activity, useful as pharmaceutical agents which can be used as therapeutic and preventing medicines in such diseases as diabetes, obesity and hyperlipidemia.

12 cl, 84 ex, 2 tbl

FIELD: chemistry.

SUBSTANCE: invention relates to the novel compounds with the formula (I) or their pharmaceutically or veterinary-acceptable salts: where: R1 and R3 independently represent H; F; Cl; Br; C1-C6alkyl; R2 represents H or C3-C7cycloalkyl; Y represents -S- or -N(R5)-, where R5 represents H; X represents the bind; R4 represents -C(=O)NR6R7, where R6 represents H or radical of formula -(Alk)b-Q, where b is equal to 0 or 1, and Alk is not necessarily substituted with C1-C6alkyl, C1-C6alkoxi, F, Cl, Br, oxo, COOH, bivalent C1-C12alkylen, C2-C12alkenylen with direct or ramified chain, which can be disconnected with one ore several non-adjacent -O-, -S- or -N(R8)-, where R8 represents H or C1-C4alkyl, C3-C4alkenyl or C3-C6cycloalkyl, and Q represents H; -SH; -NR8R8, where each R8 can be similar or different; the complex ether group; or not necessarily substituted with C1-C6alkyl, C1-C6alkoxi, phenyl, benzyl, phenoxy, C3-C8cycloalkyl, amino, fluor, bromine, oxo, -COOH, -CORA, -COORA, NHRA, -NRARB, where RA and RB are independent (C1-C6)alkyl group, phenyl, C3-C7cycloalkyl, C5-C7cycloalkenyl or heterocyclilc ring containing 5 to 8 ring atoms; and R7 represents H or C1-C6alkyl; or, taken together with atom or atoms, they are bound with, R6 and R7 form not necessarily substituted with (C1-C6)alkyl, COORA, where RA is the (C1-C6)alkyl group, phenyl, not necessarily substituted with F, Cl, Br, heterocyclilc ring containing 5 to 8 ring atoms. The invention also relates to N-(3-dimethylaminopropyl)-4-(4-cyclopropyl-3-oxo-3,5-dihydropirazol[4,3-c]quinoline-2-il]benzamide; to application of the compounds; to the immunomodulation method and to the pharmaceutical and veterinary composition.

EFFECT: production of novel immunobiologic compounds.

14 cl, 173 ex, 1 tbl

FIELD: medicine; immunology.

SUBSTANCE: method implies that animals' thymus, e.g. sea animals' thymus, is defatted and connective tissue cleaned, milled, lyophilised, degreased with liquid CO2, hydrated in isotonic phosphate buffer at pH 7.2-7.4, sediment is removed by centrifugation, supernatant is collected and warmed up at 80°C during 10-15 min, centrifugated, supernatant is collected and pH is reduced to 4.0-4.2, deposited with ammonium sulphate, formed sediment is removed by centrifugation, dissolved in tris-HCl buffer, pH 8.0-8.2, ammonium sulphate is removed on column with Sephadex G-15, material of column outer content is, lyophilised, dissolved in 0.01 M tris-HCl, buffer containing 0.14 M NaCl, pH 8.0-8.2, gel- chromatographed on column with Sephadex G-50, end product is collected by molecular weight 500 to 25000 dalton, lyophilised, dissolved in bidistilled water and desalted on column with Sephadex G-15, end product produced in column free content is lyophilised.

EFFECT: method provides higher product yield and storage stability.

1 tbl, 4 ex

FIELD: medicine.

SUBSTANCE: it is necessary to prepare a patient to therapy due to local treatment of skin and available mucosa of organs subjected to chemo- and/or radiation impact, with butyric extracts of medicinal plants; and introduction of immunomodulating preparation (IMP) and an adsorbent in the course and after the course of radiation and/or chemotherapy. Additionally, one should perorally introduce protective species comprised out of compatible pharmacopoeic medicinal plants matched with possibility for their combined protector action upon tumor-unaffected tissues of sick organ and upon the tissue of all healthy organs being in area of chemo- and/or radiation impact. As IMP and adsorbent mentioned one should apply, correspondingly, a plant adaptogen and a plant adsorbent. Introduction of species, adaptogen and adsorbent should be started while preparing a patient to chemo- and/or radiation therapy to introduce them daily in the course of therapy conducted. Local treatment of skin and mucosa should be fulfilled after each seance of radiation and/or chemotherapy. Species, plant adaptogen and plant adsorbent should be introduced at certain intervals between each other. The innovation enables to decrease traumatism of chemo- and/or radiation therapy.

EFFECT: higher efficiency of prophylaxis and therapy.

14 cl, 7 ex

FIELD: organic chemistry, medicine, chemical technology.

SUBSTANCE: invention describes a method for synthesis of 1-hexadecyl-R-(-)-3-hydroxy-1-azoniabicyclo[2.2.2]octane bromide represented by the formula: . Method involves interaction of 1-hexadecyl-R-(-)-3-hydroxy-1-azoniabicyclo[2.2.2]octane with hydrobromic acid or its inorganic salt (for example, sodium bromide or potassium bromide) in water in the ionic exchange reaction. 1-Hexadecyl-R-(-)-3-hydroxy-1-azoniabicyclo[2.2.2]octane bromide represents an immunotropic agent that shows versatile effect on human immune status and elicits antitumor, bacteriostatic and anti-aggregate effects. Invention proposes a method for synthesis of a novel synthetic low-molecular preparation possessing the expressed stimulating effect on the antitumor immunity system that is equal or exceeding by effectiveness effect of the modern domestic and foreign preparation - immunomodulators that represent natural high-molecular biologically active substances prepared by methods of genetic engineering.

EFFECT: improved method of synthesis, valuable medicinal and biological properties of substance.

1 cl, 6 tbl, 21 dwg, 4 ex

FIELD: medicine.

SUBSTANCE: invention relates to composition for inhibition or prevention of inflammatory processes associated with bacterium-mediated diseases or LTA/LPS-mediated disturbances in gastrointestinal tract in human or animal. Claimed composition contains as active ingredient lypoteichoic acid from lactic acid bacteria belonging to genus Lactobacillus wherein lypoteichoic acid was selected on the base of its capability of binding to CD 14 and disability of inducing the release of anti-inflammatory cytokines such as IL-8 or TNF-α from enteric epithelial cells. Disclosed is application of at least one lypoteichoic acid from lactic acid bacteria belonging to genus Lactobacillus, and/or lactic acid bacterium producing the same, and/or supernatant of its culture for composition production useful in inhibition or prevention of inflammatory processes associated with bacterium-mediated diseases or LTA/LPS-mediated disturbances in gastrointestinal tract, bones, skin, eyes, ears, lungs, and oral cavity in human or animal.

EFFECT: new agent for prevention or inhibition of inflammatory processes.

8 cl, 2 ex, 8 dwg

Drug // 2320333

FIELD: medicine, pharmacy.

SUBSTANCE: invention relates to drugs and concerns using pharmaceutically acceptable 2,4-dichlorophenoxyacetic acid alkaline metal salts and mixture of these salts as a drug possessing anti-tumor, immunomodulating and anti-inflammatory properties, and antiviral activity also. Invention provides expanding assortment of agents possessing the broad spectrum of curative effect being without adverse symptoms.

EFFECT: improved and valuable medicinal properties of drug.

8 cl, 18 ex

FIELD: medicine, psychiatry, neurology.

SUBSTANCE: therapeutic scheme in patients that use nootropic preparations should be supplemented with immunomodulator Halavit by a course. It is necessary to carry out 15 intramuscular injections per 100 mg. Such therapy enables to raise the impact of Halavit to higher power at treating asthenic disorders with nootropic preparations and obtain immunomodulating and smooth anxiolytic effect. That leads to improved tolerance of antiasthenic therapy and more qualitative and quicker social adaptation in such patients.

EFFECT: higher efficiency of therapy.

3 ex, 3 tbl

FIELD: chemistry.

SUBSTANCE: invention concerns new tricyclic derivatives of the formula (I) and their pharmaceutically acceptable salts, where: 1 to 3 of A1, A2, A3 and A4 are nitrogen atoms, while the rest are -CH- groups; G1 is a group selected out of -CH2-O-, -CH2-CH2-, - CH=CH-; -N(C1-C4alkyl)-CH2; G2 is a group selected out of -O-CH2-, -CH=CH-, -CH2- CH2-; R4 can be identical or different and are selected out of a group including hydrogen or halogen atoms; p are independently equal to 0, 1 or 2; Y is and optionally substituted residuum selected out of the group of alkyl, cycloalkyl, alkylaryl, alkylcycloalkylalkyl; Z is a tetrazolyl, -COOR5, -CONR5R5, NHSO2R5 or -CONHSO2R5 group, where R5 is hydrogen or optionally substituted alkyl or aryl. The invention also concerns a method of obtaining the claimed compounds.

EFFECT: possible application in treatment and prophylactics of inflammation and allergy diseases.

20 cl, 2 tbl, 46 ex

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