Method of predicting probability of unfavourable outcome of pancreonecrosis in post-operation period
SUBSTANCE: invention relates to medicine, can be used in surgery, resuscitation science. In patients with pancreonecrosis parametres of peroxide resistance of erythrocytes are evaluated and if decrease of erythrocyte chemiluminescence intensity to 61.3±9.4 and lower at the background of increase of light sum to 814.6±53.8 mV*sec and higher is registered by the third day of post-operation period, unfavourable outcome is predicted.
EFFECT: method ensures increase of accuracy, simplification and reduction of time for prediction of probability of unfavourable outcome of pancreonecrosis in post-operation period, as well as rapidity (reaction time 30-60 seconds), which allows to use it for early diagnostics of fatal complications and timely correction of intensive therapy scheme.
4 tbl, 1 ex
The invention relates to medicine, can be used in surgery, intensive care.
Known way to predict the outcome of destructive pancreatitis (RF Patent No. 2153676, G01N0 33/68, G01N 033/483, publ. 27.07.2000 g)providing a biopsy of the pancreas with the definition in biopsy samples of the concentration of malondialdehyde. The method has several disadvantages: invasiveness, technical complexity, high risk of developing complications such as parenchymal bleeding, lack of precision associated with different content of malondialdehyde in different parts of the gland with Subtotal and krupnooptovyh forms of pancreatic necrosis.
There are a predictor of complications and fatal outcome in patients with acute pancreatitis (RF Patent No. 2161804, G01N 33/84, publ. 10.01.2001, by definition acidosis in arterial blood. The method is also vysokointensivnymi, requires specially trained personnel and equipment.
Known methods for predicting outcome of acute alcohol (Patent RF №2312348, G01N 33/50, C12Q 1/68, publ. 10.12.2007,) and idiopathic pancreatitis (RF Patent No. 2310848, G01N 33/48, C12Q 1/68, publ. 20.11.2007,), consisting in the study of the genotype of the patient by polymerase chain reaction and detection of mutations in SPINK1 genes, GSTM1, GSTT1, PRSS1 and CFTR predict the development of severe pancrease the rose and the adverse outcome of the disease. These methods are costly and do not reflect the changes the severity of the patient in the dynamics of the disease.
Closest to the present invention is a method for predicting the postoperative period in surgical patients (Patent RF №2067768, G01N 33/68, publ. 10.10.1996,), consisting in a laboratory blood test in pre - and postoperative period by determining the concentration of myoglobin. When increasing concentrations of myoglobin in the postoperative period predict progressive postoperative complications with adverse outcome. The method does not take into account the specifics of complications and pathogenesis of destructive pancreatitis associated with hyperactively free-radical oxidation.
It is known that the main causes of postoperative mortality when pancreatic necrosis in the early stages is multiorgan failure in late - abdominal sepsis (Aphogee, AIA. Acute pancreatitis. - M.: Profile, 2007. - 336 S.; Vstavali, Migranov, Bergeland, Clavulanic and other Acute pancreatitis as a problem of emergency surgery and intensive care // Consilium medicum. - 2000. No. 9. - C.14-17). It is proved that the severity of multiple organ failure in acute destructive pancreatitis correlates with the level of oxidative damage to protein and lipids (Inpsect. Oxidative stress and the critical state in surgical patients // journal of intensive care. - 2004. No. 3. - 27-30). The development of abdominal sepsis according to the modern view is also accompanied by significant changes in lipid metabolism and imbalance in the system of free-radical oxidation - antioxidant protection (science Department Chairman, Vasudev, Slaman, Gdimagecopy. The state of free-radical oxidation of lipids and antioxidant defenses in sepsis from the positions of the severity of systemic inflammatory response // Intensive therapy. - 2005. No. 3. - P.32-34).
The objective of the invention: improved accuracy, simplifying and reducing the time for prediction of probability of an unfavourable outcome of pancreatic necrosis in the postoperative period.
The task to solve due to the fact that in patients with pancreatic necrosis estimate the parameters of the peroxide resistance of erythrocytes and upon registration of the decrease in the intensity of chemiluminescence of erythrocytes to 61.3±9,4 and less on the background of the increasing setosum to 814,6±53,8 mV·sec or more to the third day of the postoperative period predict adverse outcome.
The method is as follows. In patients with pancreatic necrosis in the preoperative period and on the first, third, seventh, 14 day post-operative period from the cubital is ENES take 3 ml of blood in a test tube with 80 UNITS of heparin. The test tube is centrifuged at 2000 rpm for 15 minutes, then drained the plasma. RBC mass twice washed in physiological solution of sodium chloride with subsequent centrifugation for 5 minutes at 2000 rpm after the third centrifugation, the supernatant was removed and the remaining cells are diluted five times with a physiological solution of sodium chloride and used for research. In a measuring cell of biochemiluminescence contribute 0.1 ml of washed erythrocytes; 0.4 ml of phosphate buffer (KH2PO4- 0,272 g/100 ml KCl - 0,780 g/100 ml, pH 7.5), 0.4 ml of a solution of ferric sulfate (0.01 mm to 0.14 g/50 ml), 0.2 ml lyuminola (cooked in 1 n KOH). Initiation of free-radical oxidation is performed by infusion of 0.1 ml of 2% hydrogen peroxide. Time recording is 30-60 seconds.
In the postoperative period in patients with pancreatic necrosis estimate the parameters of the peroxide resistance of erythrocytes and upon registration of the decrease in the intensity of chemiluminescence of erythrocytes to 61.3±9,4 and less on the background of the increasing setosum to 814,6±53,8 mV·sec or more to the third day of the postoperative period predict adverse outcome.
Among surveyed were persons of both sexes aged 20 to 75 years (table 1). Causes of acute pancreatitis was alcohol (46,3%), diseases of the VC is evistaa system (44,4%), and injuries of the pancreas (3,7%).
The diagnosis of pancreatic necrosis was established on the basis of the anamnesis, the clinical picture of the disease, laboratory tests, ultrasound examination of abdominal cavity and retroperitoneal space, esophagogastroduodenoscopy, according to testimony emergency diagnostic laparoscopy, CT. Verification forms of pancreatic necrosis was carried out on the basis of bacteriological examination of peritoneal exudates and content stuffing bags obtained intraoperatively during laparoscopy or laparotomy.
|Characteristics of the patients by age, gender, etiology and clinical form of acute pancreatitis|
|The average age||46,86±3,3 (20-75)|
|Gender (male/female)||35 (64,8%)/19 (35,2%)|
|Edematous pancreatitis||26 (48.1 percent)|
|Sterile pancreatic necrosis||13 (24.1 per cent)|
|Infected pancreatic necrosis||15 (27.8 per cent)|
|B is learny||24 (44.4 per cent)|
The Department conducted a comprehensive intensive infusion therapy with the use of antispasmodics, analgesics, drugs octreotide, antimetabolites, blockers H2-receptors, blood detoxification and hemodynamic series aimed at suppressing the exocrine functions of the pancreas and the decline of pancreatic taxinomie. The indication for surgery was considered progressive intoxication and multiple organ failure, in spite of complex conservative therapy within 12-24 hours or the lack of positive effects from the intensive care period longer than 72 hours from the beginning of complex conservative therapy increase clinic peritonitis, cholangitis, progressive jaundice.
All patients with pancreatic necrosis operated. Patients with sterile pancreatic necrosis (SF) was performed with video-assisted laparascopic interventions aimed at evacuation content and drainage stuffing bags and abdomen, according to testimony - cholecystectomy or x is lesistosti. In patients with infected pancreatic necrosis (IIT), as well as the development of purulent complications SF missions from mini-access with limited lesions of the gland and operation of verhnesadovogo laparotomic access abdominale pancreas, flow-proryvnym drainage and marsupialization stuffing bags, nasointestinal drainage.
The analysis of indicators peroxide resistance of erythrocytes revealed the following patterns (table 2):
|Parameters peroxide resistance of erythrocytes in patients with edematous pancreatitis in the dynamics of the disease|
|Index||The length of hospitalization (days), number of patients (N)|
|The first (N=26)||The third (N-26)||Fifth (N=22)||Eighth (N=21)|
|The maximum chemiluminescence intensity, mV||210,8±19,4*||231,2±20,6*||184,9±17,9*||141,7±12,1|
|* The significance of differences compared with normal values at P<0,05.|
In patients with edematous pancreatitis in the first days of the disease amplitude flash exceeded the normal value (136,7±10,3 MB) on average 1.55 times, sutasoma - 1.24 times (norm - 369,52±28,15 mV·sec).
On the third day of inpatient treatment there was a significant decrease in peroxide resistance, which was reflected in the excess setosum 1.56-fold compared with normal. This confirms the literature data that, in edematous pancreatitis with the rise of clinical symptoms occurs induction of peroxidation processes, content increases in the peripheral blood of toxic products and, accordingly, decreases the stability of biological membranes. In the next 5-8 days to conservative therapy indicators peroxide resistance was close to normal. This was manifested in the decrease of the maximum intensity of chemiluminescence and sutasoma that at discharge did not differ from normal values by more than 10%.
Significant differences indicators peroxide resistance of erythrocytes in sick is sterile (SF) and infected pancreatic necrosis (IDU) have been identified (table 3). The pancreatic necrosis was accompanied by persistent changes in the structure of the cell membrane, leading to more pronounced changes in the indicators peroxide resistance of erythrocytes. Unlike patients with edematous pancreatitis intensity of chemiluminescence of erythrocytes at 1.7 times, and sutasoma 2.1 times higher than the age norm. The minimum resistance of erythrocytes was observed in destructive forms of acute pancreatitis immediately after the surgical intervention. Thus, the greatest value of sutasoma coincided with the peak intensity of the chemiluminescence.
During the first weeks of the postoperative period in patients with destructive pancreatitis with a favorable course of the disease was increasing the resistance of erythrocytes, the parameters peroxidation was close to normal on the 14th day of the postoperative period.
Postoperative mortality in patients with destructive pancreatitis amounted to 32.1 per cent. Among the causes of death of three patients with sterile pancreatic necrosis, died in the early period (first five days after surgery), prevailed manifestations of multiple organ failure: cardiopulmonary and renal failure. Five patients with infected pancreatic necrosis died on the third - fourth week of the disease is t late septic multiple organ failure (3 patients) and arrozivnym bleeding (2 patients).
In the early postoperative period in patients with poor prognosis marked decrease in the intensity of chemiluminescence of red blood cells on a background of double relative to the rate of increase setosum (table 4). To the third day of the postoperative period the maximum chemiluminescence intensity of red blood cells did not exceed 61,3 MB, amounting to only 0.45 of the normal value, while sutasoma reached 814,6±53,8 mV·sec, exceeding the normal value of 2.1 times. In a further tendency to increase in peroxide resistance of erythrocytes was observed.
|Parameters peroxide resistance of erythrocytes in patients with pancreatic necrosis with fatal diseases|
|The follow-up period||Index|
|I max, MB||S, mV*sec|
|The first day after surgery||174,8±19,6||793,6±64,5*|
|The third day after surgery||61,3±9,4*||814,6±53,8*|
|The seventh days after surgery||33,6±8,4*||828,5±79,0*|
|14th day after surgery||29,8±9,4*||850,4±68,3*|
|* The significance of differences compared with normal values at P<0,05.|
Thus, the proposed method in the near term postoperative period to predict adverse outcome of pancreatic necrosis. The advantage of this method is the simplicity associated with the availability of reagents and the lack of need for specially trained personnel, and expressnet (reaction time 30 to 60 seconds), so you can use it for dynamic correction tactics intensive activities, with the threat of adverse outcome of the disease.
Statement of the case history No. 6033
Patient W., 42 years old, hospitalized in Krasnoyarsk city centre surgical pancreatology 12 December 2008 with a diagnosis of pancreatic necrosis. Etiological factor was the consumption of alcohol and fatty foods. Within 8 hours under conditions of intensive therapy was conducted infusion therapy with the use of antispasmodics, analgesics, ochre the Chida, antimetabolites, H2-receptor blockers, blood detoxification and hemodynamic number. Prophylactic intravenous assigned Meronem. Despite ongoing therapy, progressed the symptoms of endogenous intoxication. Pay attention to the initial high values of the maximum intensity of chemiluminescence of erythrocytes - 240,4 mV and sutasoma - 740,6 mV·sec.
The patient underwent surgery: performed videolaparoscopy, signs of hemorrhagic pancreatic necrosis: up to two liters of dark hemorrhagic exudate, edema and hyperemia of the round ligament of the liver, severe vascular injection parietal peritoneum, swelling anterior wall of the stomach, swelling of the greater omentum, sluggish bowel movements. Fulfilled the aspiration of exudate in the subhepatic space and to the pelvis installed tubular drains. Bacteriological examination of the microflora in the exudate was not found. Postoperative diagnosis: Subtotal sterile pancreatic necrosis. Spilled enzymatic peritonitis.
In the postoperative period against the background of comprehensive intensive infusion therapy the patient's condition remained serious. When the chemiluminescent study on the first day after surgery, there was a trend to decrease the intensity of chemiluminescence of erythrocytes with granadina high values setosum. On the second day decrease in the intensity of chemiluminescence of erythrocytes was achieved 104,5 MB, coupled with a progressive increase in setosum to 870,4 mV·sec regarded as prognostic of adverse outcome of the disease.
Patient assigned additional laboratory and instrumental investigations (full blood count, examination of blood gas composition, immunological, triglycerides, x-ray examination of the chest, fibrogastroduodenoscopy). On the third day of the postoperative period according to the results of additional studies diagnosed the phenomenon of multiple organ failure with involvement in the pathological process of the lungs (the syndrome of acute lung injury ALI), the hemostatic system (consumption coagulopathy).
Inclusion in the complex of therapeutic measures oxygenotherapy, infusion of fresh frozen donor plasma contributed to the compensation function of the respiratory system and hemostasis. According to the chemiluminescent studies on the seventh day of the postoperative period there is a tendency to normalization peroxide resistance of erythrocytes: the maximum chemiluminescence intensity was increased to 115,4 MB, sutasoma decreased to 570,3 mV·sec. On the eighth day the patient was transferred to the General surgical ward. The development of the settlement of the necrotic complications were noted. At 18 days the patient was discharged in satisfactory condition.
Thus, taking into account parameters peroxide resistance in a prospective prediction of outcome of pancreatic necrosis can prevent the development of fatal complications of the disease through early detection and timely correction scheme intensive care.
Method of predicting the likelihood of adverse outcome of pancreatic necrosis in the postoperative period, including laboratory blood testing in pre - and postoperative period, characterized in that in patients with pancreatic necrosis estimate the parameters of the peroxide resistance of erythrocytes and upon registration of the decrease in the intensity of chemiluminescence of erythrocytes to 61.3±9,4 and less on the background of the increasing setosum to 814,6±53,8 MB·and more to the third day of the postoperative period predict adverse outcome.
SUBSTANCE: test-element has surfaces located at set distance opposite each other and containing two similar structures that form sections with high and low surface energy. At least one of sensitive sections of the first and second surfaces is provided with at least one element of non-enzymatic recognition able to provide reaction of affinity with analysed substance. Method of test-element manufacturing includes formation of sections with high and low surface energy on bottom layer with the first surface. Sections with high surface energy form hydrophilic system of sample distribution, formation of structure of sections with high and low surface energy on upper layer with the second surface, covering given sensitive sections of the first surface with calibration compositions, covering given sensitive sections of the second surface with recognition composition, which contains recognition element, and application of layers of the first and second surfaces onto opposite sides of central layer with a cut. Described is test-system which includes test-element by i.i. 1-15, and method of qualitative and/or quantitative determination of at least one analysed substance in a sample of physiological or water liquid, using application of physiological sample liquid on test-element by i.i. 1-15.
EFFECT: increase of analysis accuracy.
26 cl, 21 dwg, 2 tbl
SUBSTANCE: to detect the lifetime paranecrotic changes of tissues and skeletal system in experimental animals, average weight molecules in blood plasma are evaluated by spectrophotometric analysis in the wave length range 250-300 nM. The derived data are estimated by the area of a figure formed by an absorption curve and a zero mark axis. If the average weight molecules are increased in relation to the initial level in the wave length range 250-270 nM, the lifetime paranecrotic changes are observed.
EFFECT: method allows detecting the paranecrotic changes in tissues and skeletal system of experimental animals without killing.
1 ex, 1 tbl
SUBSTANCE: before and after local ischemia, diametre of the brachial artery, blood nitrite level, endothelin concentration and Willebrand factor are evaluated. The accommodation of vascular wall endotheliocytes to ischemia is calculated by formula that describes a coefficient Ken. If Ken is "0" or less, the adaptation of the vascular wall is considered as preserved; Ken within "0" to 0.2 inclusive shows the moderately lowered adaptation of the vascular wall, while the Ken value exceeding 0.2 indicates the considerably lowered adaptation of the vascular wall. The coefficient Ken may be used for a quantitative estimation of specific features of cell functional adaptation to ischemic factors, both in norm, and in cardiovascular pathology.
EFFECT: use of the invention allows reducing the acquisition time in 3 times, objectively assessing the endothelium adaptation to ischemia.
SUBSTANCE: invention refers to medicine, particularly to morphology and histochemistry. Computer analysis is implemented by photography of histological drugs processed by Cross-Ewen-Rost method with orthophthalic aldehyde, and photography assessment. Digital photography is applied, and histamine concentration is determined at software level by mean brightness of an digital image site measured in reference luminosity units within 0 to 255 in graphic editors.
EFFECT: extended range of histamine concentration determination methods for biological structures.
4 dwg, 1 tbl
SUBSTANCE: invention belongs to experimental and clinic medicine, notably to medical biophysics, clinic pharmacology, biochemistry, oncology and immunology. For antioxidant activity assessment, test specimen of an oxidant is injected into biological target, and then in target free-radical oxidation is induced. Antioxidant activity is assessed by optical density of the patterns within photometry. As biological target whole blood with addition of citrate or heparin is used. Test specimen of an oxidant is injected in 5% suspension made of whole blood, after incubation 10 mcl of 1 mM clotrimazole suspension is added. To induce oxidation 20 mcl of 100 mM tert-butyl hydroperoxide solution is added. Mix is once again incubated, centrifuged, and then supernatant's optical density is measured.
EFFECT: method allows increasing of accuracy and effectiveness of antioxidant activity assessment in natural and chemical compounds and biological liquids.
6 cl, 2 dwg
SUBSTANCE: invention belongs to medicine, notably to morphology and hystochemistry. In this method of histamine rate assessment in epithelial cells of rats endometrium within sex cycle, sample acquisition and following fluorescent-histochemical analysis with orthophtalic aldehide is made. In each phase of sex cycle histamine rate assessment in vaginal content is made. Assessment's result is compared with rate of histamine which is 0.50±0.07 at early estrus stage, 0.34±0.04 at late estrus stage, 0.68±0.08 at metaestrus stage, 0.72±0.12 at early diestrus stage, 0.75±0.13 at late diestrus stage, 0.87±0.11 at proestrus stage. Measurement unit is conventional unit of measuring device. When rate of histamine in vaginal content is below control value the rate of histamine in epithelial cells of endometrium is assessed as reduced, if it exceeds control value same does the histamine rate in endometrial cells.
EFFECT: improvement of evaluation accuracy.
2 tbl, 2 ex
SUBSTANCE: invention refers to medicine, namely to forensic medicine, and can be used for late postmortal detection of prescription of death coming. The optical density of vitreous body is measured. The prescription of death coming is calculated provided a corpse kept at an ambient temperature +10°C to +20°C by formula: PDC=1.975+5.641×OD335+13.924×OD405-16.023×OD475+6.938×OD545, where PDC is the prescription of death coming, (days); OD335 is the optical density of vitreous body at wavelength 335 nm; OD405 is the optical density of vitreous body at wavelength 405 nm; OD475 is the optical density of vitreous body at wavelength 475 nm; OD545 is the optical density of vitreous body at wavelength 545 nm, and at ambient temperature +21°C to +30°C by formula: PDC=1.129+136.486×OD365-134.091×OD375+10.269×OD405, where PDC is the prescription of death coming, (days); OD365 is the optical density of vitreous body at wavelength 365 nm; OD375 is the optical density of vitreous body at wavelength 375 nm; OD405 is the optical density of vitreous body at wavelength 405 nm.
EFFECT: method is accessible, simple and characterised by high accuracy.
SUBSTANCE: tumour region and surrounding intact tissue receives the diagnostic exposure prior to the series low-intensity lasing source exposure that is carried out at average radiation power 1-10 mWt, wavelength 370 nm with recording the tissue-escaping intensity of back-scattered fluorescence at wavelengths 420, 460 and 520 nm. Thereafter, the tumour region and the surrounding intact tissue are exposed to the low-intensity lasing fluorescence at wavelength 532 nm with recording the tissue-escaping intensity of back-scattered fluorescence at wavelengths 560 and 608 nm. Then the immunohistochemical analysis additionally precedes the treatment with recording the Ki-67 antigen expression level of that tumour region exposed to the low-intensity lasing to determine a prediction criterion P1 by the initial Ki-67 antigen expression level; there is evaluated the relation of fluorescence intensities at wavelengths 420/460 nm, 460/520 nm, 560/608 nm derived from the tumour surface Ii:K2=I420/I460, K3=I460/I520, K4=I560/I608 and in the intact region I'i:K'2=I'420/I'520, K'3=I'460/I'520, K'4=I'560/I'608 to calculate the relation of the tumour/intact tissue fluorescence intensity at wavelengths 420/460 nm, 460/520 nm, 560/608 nm: K2/K'2, K3/K'3, K4/K'4; if the Ki-67 antigen expression > 65%, the prediction criteria P1 are considered to be equal to +1, the expression 45-65% shows P1=0, the expression <45% requires P1=-1; the prediction criteria P2, P3, P4 are derived from the results: P2, P3, P4=+1 respectively at K2/K'2<1, K3/K'3<1, K4/K'4<0.5, P2, P3, P4=0 respectively at K2/K'2=1-4, K3/K'3=1-1.4 K4/K'4=0.5-1.5, P2, P3, P4=-1 respectively at K2/K'2>4, K3/K'3>1.4, K4/K'4>1.5, while the radiation sensitivity is determined by total prediction criteria, and P1+P2+P3+P4>0 indicate high radiation sensitivity, P1+P2+P3+P4=0 ensures moderate radiation sensitivity, while in P1+P2+P3+P4<0, low radiation sensitivity is observed.
EFFECT: method simplifies prediction of the results prior to the therapeutic course by tumour sensitivity to ionising radiation, improves its reliability that allows correcting the management program.
1 tbl, 3 ex
SUBSTANCE: patient's blood serum is tested by infrared spectroscopy. It involves recording peak heights of absorption bands in the range 1170-1025 sm-1, evaluating absorption spectrum, expressing the related values as the regions of "disease patterns" in a coordinate system (x; y) with the coordinates: (x // y): -1.8325/2.2800; -1.3175/2.8650; -1.1468/1.7903; -1.1887/1.3774; -1.0694/0.4032; -1.8500/0.4000; -1.8242/1.6452 - showing clinical effectiveness, and the coordinates: (x // y): 1.1575/2.1000; -1.1274/1.7774; -1.1726/1.3710; -1.0575/0.4200; -0.3775/0.8900 indicating lack of effect.
EFFECT: more accurate and accelerated discovery of estimation of clinical effectiveness.
1 dwg, 2 ex
SUBSTANCE: blood plasma is analysed for cytochrome oxidase activity; concentrations of 2,3-diphosphoglycerate and lactic acid in erythrocytes are evaluated. Then oxygenation coefficient K is calculated by formula: K = (C1+C2):A, where A is plasma cytochrome oxidase activity, mol/l; C1 - concentration of 2,3-diphosphoglycerate in erythrocytes, mol/l; C2 - concentration of lactic acid in erythrocytes, mol/l. If said oxygenation coefficient is more than 1.0, hypoxia is diagnosed.
EFFECT: technique allows improving reliability of hypoxia diagnostics and reducing acquisition time to 4 hours.
SUBSTANCE: invention relates to medicine, in particular to devices for puncture morphologic diagnostics of soft tissue tumours. Device for puncture morphologic diagnostics of soft tissue tumours includes needle connected with syringe, guide needle and insulation catheter. Surface of operational needle is made sharp-ended rough with at least three lateral aspiration holes located on it. Operational needle with insulation catheter are placed inside guide needle.
EFFECT: simplification of construction, increased reliability and possibility of morphologic tumour diagnostics in fact in all cases, elimination of risk of hematogenic spread of metastases, guarantees of hemostasis.
SUBSTANCE: invention relates to field of medicine, namely to neurosurgery, neurotraumatology and clinical neurology. Before beginning and in dynamics of treatment clinical and laboratory parametres are determined. Each parametre is evaluated in points. Obtained points are summed up, degree of toxemia expressivity (Dt) is determined by formula: Dt=(ΣP-c+ΣP-l)/lim(ΣP-c+ΣP-l)×100%, where ΣP-c is sum of points of clinical parametres, ΣP-l is sum of points of laboratory parametres. Obtained data with clinical and laboratory parametres are input into computer programme, carrying out computer monitoring in dynamics.
EFFECT: method allows to reduce time of diagnostics and increase its efficiency.
4 tbl, 2 ex
SUBSTANCE: invention relates to medicine, namely to morphological analysis in oncology. In order to evaluate efficiency of intramural aotoplasmochemical therapy of urine bladder cancer reactions with markers of proliferation and apoptosis factors are carried out. In case of decrease of proliferative activity Ki-67 14.3±3.41%, of p53 expression 10%, of apoptotic index 0.53±0.13, in case if AE1/AE3 cytokeratin expression in vessels of microcirculation stream is absent, if pronounced AE1/AE3 cytokeratin expression in urothelial epithelium is preserved, reduction of recurrences and metastases is predicted.
EFFECT: method increases evaluation of treatment efficiency, chemical prevention of local recurrences and progressing of superficial cancer of urinary bladder into muscular layer.
3 dwg, 1 ex, 2 tbl
SUBSTANCE: invention relates to medicine, namely to traumatology and orthopedics. In order to predict development of endoprosthesis instability after total endoprosthetics in connection with osteoarthrosis of hip joint, patient's blood serum is tested. Level of primary, secondary and final isopropanol-soluble products of lipid peroxidation (ISPP, ISSP, ISFP) and ascorbate-induced lipid peroxidation (AOA-1, AOA-2) is determined. ISPP, ISSP, ISFP levels are analysed on 10-14 day after operation, as well as 3 and more months after operation. AOA-1 and AOA-2 levels are analyzed only on 10-14 day after operation. Level of primary, secondary and final isopropanol-soluble products of lipid peroxidation and ascorbate-induced lipid peroxidation relative to norm on 10-14 day after operation and 3 and more months after operation is used to predict development of endoprosthesis instability after endoprosthetics of hip joint.
EFFECT: method is simple, available, efficient for long-term prediction of instability development.
SUBSTANCE: invention relates to field of medicine, namely to clinical laboratory diagnostics. For morphological analysis facies of biological fluid is obtained using device which creates radial magnetic field with value of magnetic induction 0.06 T and field gradient 0.01 T/mm. Biological fluid is preliminarily centrifuged, supernatant is applied on microscope slide in volume 0.004 ml. Slide with a drop of biological fluid is installed in such way that the centre of the drop which is dried projectionally corresponded the apex of come-shaped element of the device. The drop of biological fluid is dried during not less than 12 hours. Device for preparation of biological fluid, including magnetic field source, is made in form of cylindrical steel platform, in whose centre cone-shaped element is fixed. Source of magnetic field is made in form of circular magnet, placed on platform edge and creating magnetic field with value of magnetic induction 0.06 T and gradient 0.01 T/mm.
EFFECT: elaboration of method of preparing biological fluid for morphologic analysis.
9 dwg, 3 ex
SUBSTANCE: man's age, weight, presence of fractures in medical history, presence of rheumatoid arthritis are determined. Value of Fm index is calculated by formula: Fm=(A-B)/20+3×C+D-0.2; where A is patient's age (number of complete years); B is patient's weight (number of full kilograms); C is coefficient which shows presence of fractures and takes value 0 or 1: C=1, if in last 10 years patient had low-traumatic fracture, C=0, if there are no fractures in medical history; D is coefficient which shows presence of rheumatoid arthritis and takes value 0 or 1: D=1, if patient has diagnosis "rheumatoid arthritis", D=0, if patient does not have rheumatoid arthritis. In case if Fm>0, osteoporosis is diagnosed, if Fm<0, it is concluded that there is no osteoporosis.
EFFECT: method allows to increase efficiency of diagnosing systemic osteoporosis in men over 50 years old.
2 tbl, 1 dwg
SUBSTANCE: invention relates to medicine, namely to gastroenterology. To diagnose intrahepatic cholestasis at polyviral hepatitis, biochemical and immunology research are carried out. Additionaly morphological study is conducted. At level increase of alkaline phosphatase up to 200 u/l and more, gammaglutamyltranspeptidase up to 100 u/l and more, the level of immunoglobulin IgM up to 215 mg % and more, with evident fatty degeneration of hepatocytes with a predominant increase in the level of average and droplet particles of achromatous lipids with intracellular cholestasis, vacuolar degeneration of hepatocytes and the presence of foam cells and deformed dark-colored red blood cells in sinusoids, degeneration of cholangiocytes, intrahepatic cholestasis is diagnosed.
EFFECT: method increases accuracy of diagnosis of intrahepatic cholestasis at lipid peroxygenation and viral hepatitis.
2 ex, 2 tbl
SUBSTANCE: invention relates to medicine, namely to neurosurgery, neurotraumatology. Digitisation of gradation of signs identified at examining the patient is carried out. Gradation of signs are evaluated in points. The total risk score (SUM) is calculated by the formula: SUM = X1 + X2 + X3 + X4, where X1 is the stage of traumatic dislocation syndrome: I stage - 1 point, II stage - 2 points, III stage -3 points, IV stage - 4 points, V stage - 5 points; X2 is the percentage of reduction in average arterial blood pressure (AABP) in the preoperational and operational periods in relation to the original AABP: reduction of less than 10% - 0 points, 10-24% - 1 point, 25-40% - 2 points, more than 40% - 6 points; X3 is the percentage of AABP reduction in the postoperative period in relation to the original with AABP: decline or equal to 10% - 0 points, 11-20% - 1 point, 21% or more - 2 points; X4 is presence of septic complications: No - 0 points, pneumonia - 1 point, meningoencephalitis - 2 points. With the value of SUM is less than 4, a favorable outcome is predicted, and at the value of SUM equal to or more than 4, fatal outcome of severe traumatic brain injury is predicted.
EFFECT: method enables to improve prognosis accuracy and simplify the calculation procedure.
1 tbl, 2 ex
SUBSTANCE: invention relates to medicine, namely to traumatology and orthopedics. To prognosis progression of endoprosthesis instability after total endoprosthesis replacement on deforming coxarthrosis, seroscopy of the patient is conducted before surgery and 3 months after it. Additional seroscopy of the patient is conducted in 10-14 days after surgery. The level of ferritin and ceruloplasmin is detected. At increase of relative to normal levels of ferritin and ceruloplasmin before surgery, in 10-14 days and after 3 months or more, predict progression of endoprosthesis instability in the bone after hip endoprosthesis replacement.
EFFECT: method is inexpensive, simple, effective and a long-term prognosis of progression of endoprosthesis instability.
SUBSTANCE: invention relates to medicine, namely to gastroenterology. To assess regeneration of gastric ulcers and duodenal ulcers, morphological study is conducted. The initial stage of regeneration is determined in case of simultaneous presence in the periultserose area of fibroblasts with well-developed system of granular endoplasmic reticulum and mast cells with forming specific granules. The final stage of regeneration with formation of scar is determined at presence of reduction of the granular endoplasmic reticulum in fibroblasts and degranulation of mast cells.
EFFECT: method increases accuracy of assessment of regeneration of gastric ulcer and duodenal ulcer.
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