Method of estimating local inflammation activity in case of background neck of uterus diseases and device for removal of native material from neck of uterus surface

FIELD: medicine.

SUBSTANCE: in estimation of local inflammation activity in case of background diseases of neck of uterus sampling of analysed biomaterial is performed by bringing of device for native material removal to external neck of uterus fauces. Said device has elongated holder in form of rod with length, exceeding length of vagina. From distal side of rod, at angle to it, located is operation element in form of roller. Proximal end of rod serves as manipulator-handle. Sampled material is placed until complete submergence into tightly closable test tube, filled with 1.0 ml of 0.155 M solution of sodium chloride. Mixture is centrifuged for 10 minutes. Obtained materials are analysed by method of solid phase ELISA analysis on boards by means of set of reagents "Vector-Best". Concentration of cytokine of interleukin-6 in analysed samples is determined spectrophotometrically. If value is higher than 50 pg/ml to 92 pg/ml, conclusion about presence of chronic inflammation process is made. If value is higher than 92 pg/ml, conclusion about active course of inflammatory process and expressed immune response is made.

EFFECT: application of method allows to increase quality of analysed native material and accuracy of obtained result without complicating analysis process.

2 cl, 3 ex

 

The invention relates to the field of medical equipment and medicine to practical and experimental. Can be used in gynecology, clinical laboratory diagnostics for studying the activity of local inflammation of the mucous membrane of the cervix to choose an adequate method of treatment.

It is known that an increase in the frequency of precancerous and malignant neoplasms of the cervix, especially in young women, due to a combination of background pathology with chronic cervicitis [Etiology, pathogenic aspects, optimization of diagnostics and therapy of chronic cervicitis / Aaaaaa, Elizatko, bi Medvedev // proceedings of the VI all-Russian forum "Mother and child". - Moscow, 2004. - S-368].

The frequency of cervicitis caused by a bacterial infection, is 40-50%. In the last decade for inflammation of the cervix is characterized by the absence of a clear clinical picture, the tendency to long for, recurrence, which leads to the formation of morphological changes on the surface of the cervix, and its thickness [Effect of infection on the reproductive system of women / Vigersky, Oferowa, Whatamango etc. // Herald of the Russian obstetrician-gynecologist. - 2004. No. 5. - P.39-41]. Inflammation in response to chronic infection leads to the production of nonspecific semitrajectory oxidants, causing oxidative damage to the DNA of the host cell. Known link elevated proinflammatory cytokine interleukin-6 with cervical intraepithelial neoplasia. [Microbiocenosis of the vagina and cervical pathology. The possibility of correction of dysbiotic conditions / Ibbenburen, Genkina, Ustalenia // Outpatient gynecology. Clinical lectures / edited by Prof. Vinpalace. - 2nd ed., supplementary - M: Medpress-inform, 2005. - P.37-46]. In parallel with inflammation develops local secondary immunodeficiency cellular and humoral immune responses [Role of inflammation in the diagnosis and treatment of cervical pathology / Minkota // Gynaecologist. - 2005. No. 12. - P.27-30]. Ectopia of the cervix also applies to background pathology and is one of the first places in the structure of gynecological morbidity [Rudakova E.B. Pseudo cervical / Practical gynecology. Clinical lectures / edited by Acad. The RAMS V.I. Kulakov, Professor Vinpalace. - 3rd ed., supplementary - M: Medpress-inform, 2006. - P.40-48].

Known various methods of diagnosis, evaluation, research background of the cervix of the uterus in the form of patented medical technology: [RU patent for the invention №2134535 "Method for the diagnosis of inflammatory diseases of the cervix]. Based on the effects of alternating current on the cells of the investigated organ in the background with the food - lactic acid, diluted in distilled water, for a complete cessation of biokinetic, 20 minutes later diagnosed with inflammatory diseases of the cervix; [RU patent for the invention №2240040 "Method for the diagnosis of inflammatory diseases of the cervix]. Based on the color Doppler mapping of the uterine and vaginal arteries; [RU patent for the invention №2240041 "Method for the diagnosis of inflammatory diseases of the cervix]. Based on more advanced colposcopy in the detection volume of the inclusions in the thickness of the neck with two-dimensional sonography and identifying them in capsules with three-dimensional sonography.

However, all the above methods for establishing inflammatory diseases of the cervix it is impossible to judge the extent of its activity and the state of local immunity of the cervix.

The disadvantages of all these methods is the lack of information about the extent of activity diagnosed inflammation. Also known "Method for the diagnosis of ectopia of the cervix in women of reproductive age" [RU patent for the invention №2306569], based on the study of follicle-stimulating hormone, luteinizing hormone, estradiol, and progesterone in the serum by ELISA.

However, enzyme-linked immunosorbent assay ELISA examine the contents of hormones in the blood, this too is only allows you to diagnose uncomplicated hormone-dependent ectopia.

Also known assessment of immune status using cytokines. Currently, the diagnostic significance in assessing the level of cytokines is to underline the fact of increase or decrease of their concentration in a particular patient with a particular disease. A Central role in local and systemic, acute and chronic inflammation plays interlekin-6 - YL, which belongs to the group of proinflammatory cytokines [Comparison of sets of reagents for determination of interleukin 1 beta and interleukin 6 two different manufacturers / Thegranite, Nahrain, follower of N.V. Timofeev // Journal "cytokines and inflammation". - 2007. No. 2. - p.70-72].

There is a method of determining the content IS in vaginal discharge in patients with underlying diseases of the cervix [Karaeva NV Optimization of complex treatment of the underlying diseases of the cervix in women of reproductive age: author. dis. Kida. the honey. Sciences / Russian state medical University. - Moscow, 2007. - 21 S.].

However, the study of cytokines in vaginal discharge does not give reliable information about the state of local immunity of the cervix, because the blood sampling produce far enough away from the pathological tissue. Protective role of proinflammatory cytokines is manifested locally, in inflammation, so it is advisable to measure the x levels in relevant tissues.

The closest in technical essence to the proposed method is a method of research content IS in the mucus of the cervical canal by the method of solid-phase ELISA in patients with Candida cervicitis, in which the sampling is carried out using a universal probe [Chronic recurrent vulvovaginal candidiasis: therapy / Vinpalace, Asiakirja, Gribanova etc. // Journal "Gynecology" V.9, No. 3. - 2007. http: //www.consiliummedicum.].

However, in the study of cytokines in cervical content data may be distorted in the presence of inflammatory diseases of the upper section of the genitals.

It is also known "Device for collecting cytological material from the cervix" [inventor's certificate SU # 1779334], containing a hollow body placed in it a rod with cutting edges and handle. The body is made with a through channel and a cutting edge at the working end, and cutting the tabs of the rod are located on its working end, and half of them made a pyramid, and the other half in the form of inclined radial blades.

It is also known Device for collecting diagnostic material cervix" [inventor's certificate SU # 839496]containing the handle, turning into the rod and the working part of the conical shape. The taper of the working part is made with a Cup-shaped flange having a radius of whom died, moreover, the cone and Cup-shaped Board is made perforated.

It is also known "Device for collecting cytological material" [RU patent for the invention №2019146]containing the handle, neck and head with intake element. The head is made in the form of a directional peak forward triangular front and side elastic plate with concave sides and edges, and pick up items in the form of elastic tape frames in the ribs, made in the cross-section of a triangular shape at the ends with a gathering and are located in the plane of the sides opposite to the direction of rotation of the head.

However, these devices are complicated, cumbersome and do not exclude the possibility of injury in varying degrees of the surface.

A device in the form of a universal probe used in the technology of the fence mucus from the cervical canal [Chronic recurrent vulvovaginal candidiasis: therapy / Vinpalace, Asiakirja, Gribanova etc. // Journal "Gynecology" V.9, No. 3. - 2007. http:// www.consilium medicum].

However, when the sampling of biological material using a universal probe, it is difficult to exclude the complete absence of trauma, because the device is injected directly into the cervical canal and do not exclude the possibility of injury to its walls.

Known also Nikon is CNIC for collection of cervical mucus, which is a metal tube at the distal end of which there are holes on the top has four radially spaced side openings that allows erosion and fence material from critterville channel for research purposes [the Performance of local humoral immunity before and after treatment of inflammatory diseases of the cervix and vagina / Senchuk YA, Michalski L.A., Rogachev VP - 2004. http: // www.medi.ru].

The closest analogue to the proposed device is a device for collecting the studied material, which is a sterile graduated glass pipette [System proinflammatory cytokines in cervical secretions in women with urogenital chlamydiosis / Oahlinger, Dry // Journal "cytokines and inflammation". - 2006. - V.5 No.4. - s-16].

However, in the study of biological material obtained from the cervical canal with a glass pipette, there may be corruption of data in the presence of inflammatory diseases of the upper section of the genitals.

The objective of the proposed method is to increase the ease of implementation of the evaluation process activity in the local inflammation while maintaining the high accuracy of the result.

The task of the claimed device for collecting the studied material from the surface of the cervix is simplified the e design while achieving the possible traumas mucous when it is used.

The essence of the proposed method of assessing the activity of the local inflammation in the background cervical cancer is characterized by the fact that after clinical examination and verification of diagnosis patients produce with maximum fullness and noninvasive collection of the investigated product, summing device for removing native material to fix the outer cervix directly to the surface of the transformation zone of the cervix and of the pathological focus, not entering the device inside the cervical canal, then place the collected material to complete immersion in a tightly closed tube filled with 1.0 ml 1,M solution of sodium chloride, the mixture is shaken in a centrifuge vortex for 10 minutes, examine the materials obtained by the method of enzyme-linked immunosorbent analysis of IFA tablets by using a set of reagents "Vector-best", carry out spectrophotometric determination of the concentration of the cytokine interleukin-6 in the studied samples, judged on the activity of local inflammation at concentrations of interleukin-6 in comparison with its normal concentration, equal to the value of 50 PG/ml in healthy individuals from the reference group, and if the value is above 50 PG/ml to 92 PG/ml judged on the presence of a chronic inflammatory process, if the value is above 92 PG/ml - judge the presence of actively flowing FOTS is long process and expressed immune response.

Applying the method with the above-described characteristics, in which case the presence of scarring on the surface of the cervix collection of the investigated material is carried out from the surface of the transformation zone with strips of filter paper-applicator 1×0.4 cm

The essence of the claimed device for removing native material from the surface of the cervix is characterized by the fact that it has a long holder in the form of a rod with length at least exceeding the length of the vagina, with the distal side of the rod at right angles to it posted by a work item in the form of a roller having a coating of removable vysokochastotnogo material developed absorbing surface, the proximal end of the rod serves as a manipulator handle, roller configured to move along the surface of the face side in the area of the external OS, with the possibility of rotation around its axis and changes its position from horizontal to vertical switching device handle.

Applying the device with the above-described characteristics and optimal dimensions of the components and parts:

holder length - 200÷220 mm;

the length of the roll - 7÷10 mm;

the diameter of the roller - 4÷6 mm;

the thickness of the coating roller - 0,3 mm

The technical result of the claimed group of inventions is that elevated the e accuracy in the evaluation of the activity of inflammation of the cervix is produced based on the data obtained directly from the site of pathology in the form of information from native samples, which gives more authenticity to the research, which was absent in the closest analog. Achieved this result technically: the sample is shaken by centrifuge vortex, the process being examined by ELISA with the use of technical means. Device for removal of native material from the surface of the cervix, as well as others used in the claimed method of the device is its technical attributes.

Since the method is based on the use of the cytokine interleukin-6, which is a local measure, it is advisable to measure its level directly in the target tissue, in this case the cervix.

Changed quantity of the cytokine interleukin-6 is a sign of immunodeficiency and an indicator of the disease. This application was studied immunoactivity specific organ-specific pathological areas of the body - inflammation of the cervix enzyme-linked immunosorbent assay, which was carried out on pre-manufactured tablets JSC "Vector-best", Novosibirsk, Russia. Profitability analysis - spectrophotometrically at a wavelength of 450 nm. To determine the values of normal concentrations of interleukin-6 was the analysis of healthy female donors reproductive is on aged 25 to 44 years, representatives of different social groups without any genital diseases at the present time and in the past, primarily the cervix. All named to this phase of the method of characteristics included in the methods of implementing the method, are of a technical nature, such as the IFA and the peculiarities of its implementation. Features collection of the investigated material are of a technical nature - how to collect and what to study and how to handle it to ELISA, and most importantly, what natural liquid selected for study. In the vast majority for the study of the body of the cervix at the given pathology is used for ELISA analysis of blood, less the contents of the cervical canal, in the inventive solution is investigated detachable cervical glands from the surface of the transformation zone of the cervix.

Activity and the accuracy of the localization of the inflammatory process of the cervix confirmed undeniable, for example, if there are multiple inflammatory processes sluggish and/or current active simultaneously in the same organism. For example, the presence of complicated ectopia and pneumonia or flegmonoznih diseases simultaneously in the same body in other methods, for example, analysis of blood even on cytokines, it is not possible to assess the activity of inflammatory diseases of the cervix separately from the other comorbidities.

Detailed description of the method.

Initially, carry out clinical examination of the patient using standard methods, i.e. with the assessment of complaints and somatic status, detailed history taking to identify factors that affect immune status, gynaecological examination with inspection of the cervix with the help of mirrors, bimanual examination, the expanded colposcopy, Cytology of scraping from the cervix. Then further examined for the presence of infections of the genitals, i.e. they perform the microscopy of stained smears from the urogenital tract, bacteriological content of the cervical canal. The polymerase chain reaction examined for infections transmitted mainly through sexual contact. Conduct verification of the diagnosis, exclusion criteria from the study were: pregnancy and lactation, inflammatory diseases of the pelvic organs and external genitalia in the acute stage, the presence of sexually transmitted infections, including human papillomavirus infection, the presence also of cervical intraepithelial neoplasia and cervical cancer, the presence of severe extragenital pathology and symptoms of acute infectious diseases.

After clinical examination of patients and confirm the presence of non-specific inflammation of the cervix match is responsible for collection of biological material from the surface of the nidus and the transformation zone. Collection of biomaterial is as follows: the patient is placed on the gynecological chair, cervix naked in mirrors Cuzco. Sterile dry cotton swab to remove the vaginal discharge from the surface of the cervix. Then produce the maximum extent and noninvasive collection of the investigated product, summing the inventive device for removing native material to fix the outer cervix directly to the surface of the transformation zone of the cervix and of the pathological focus, not entering the tool inside the cervical canal.

Claimed in this application the device for removal of native material from the surface of the cervix has a removable coating of vysokouglerodistogo material, placed on a rotating platen. With the proximal end of the holder is made manipulator handle. The roller is made to be attached to the distal end of the holder and can be moved along the surface of the face side in the area of the external OS, with the possibility of rotation of the roller around its axis and changes its position from horizontal to vertical toggle manipulator handle. The authors experimentally selected geometrical dimensions of unit: length holder - 200÷220 mm, the length of the roll - 7÷10 mm, the diameter of the roller - 4÷6 mm, the thickness of the coating roller - 0.3 mm on the basis of anatomical razmerov modern requirements medicine - possible traumas, painlessness. After a full exit from the genitals carry out taking vysokouglerodistogo cover with native material and placing it in a solution.

Device for removing native material may also be a filter paper applicator of appropriate sizes. Sorption capacity of the filter material at the maximum absorption prorated control studies. A strip of filter material is weighed before and after soaking on an analytical balance. The light strip of filter material with a size of 1.0×0.4 cm with tweezers firmly fixed to the surface of the nidus, delicate gentle pressure tweezers enable the filter material to absorb inflammatory secret cervical glands and components damaged tissues within 15-20 s, and the size of the filter material, as a rule, allows to obtain up to 5.0±0.5 mg of native material. This device is used in the case of scarring on the surface of the cervix, using him collect the studied material in the form of separate cervical glands from the surface of the transformation zone. Described in this application techniques removal of native material provide maximum completeness of the collection and atraumatic the awn unlike most similar analogue, when cervical secret taken from the cervical canal, and not with the zone of the nidus and the transformation zone, as in the claimed method.

Then, the sample is placed in a numbered test tube up to full immersion, filled with 1.0 ml 0,155M solution of sodium chloride, cover with a lid. Wash biomaterial surface of the filter material is carried out in a centrifuge vortex CM 70M-07, Elmi for 10 min in the mode of shaking. Then the test tube is placed into the holder.

Analyzed the test material is separated from the mucous membrane of the cervix, diluted 1:200 in 0,155M solution of sodium chloride.

Samples are tested by the method of enzyme-linked immunosorbent assay ELISA. The analyzed sample in the amount of 100 μl make the hole in the tablet using an automatic pipette. In the first stage of analysis IS contained in the calibration and test samples associated with the first antibody immobilized on the inner surface of the wells. In the second stage analysis of immobilized IL interacts with the conjugate of the second antibody with Biotin. The amount of bound peroxidase is proportional to the number IS in the sample. At the last stage of the analysis in the wells contribute avidin-peroxidase. During incubation with substrate mixture with a solution of tetramethylbenzidine produced the wears the colour of the solution in the wells. The degree of coloration is directly proportional to the amount of bound peroxidase labeled antibodies. After measuring the optical density of the solution in the wells using immunoassay analyzer, "Stat Fax-2100" at a wavelength of 450 nm on the basis of the calibration curve obtained in the study of calibration samples, available in a set of reagents, calculate the concentration IS in the analyzed samples. The results are expressed in PG/ml Total analysis time 90-100 minutes

Method of solid-phase ELISA testing of freshly prepared samples. If this is not possible, to exclude bacterial gains tubes with the samples placed in the freezer and implement storage at t -20°C. it does not allow even a single thawing of samples.

To obtain quantitative values of the reference standards the concentration of interleukin-6 in advance determined in the discharge from the mucous membrane of the cervix uteri in 20 healthy individuals women of reproductive age 25-44 years and carried out the construction of the calibration curve. The concentration of the obtained values for them amounted to 50 PG/ml for the majority of healthy individuals value amounted to within the value of 30.9 PG/ml.

In 20 patients with acute inflammation or acute exacerbation of chronic inflammatory process in age from 24 to 44 year range measured value of the concentration IS accounted for more than 92 PG/ml For most patients these values fit around 158-160 PG/ml.

In 20 patients with long-term and low-intensity chronic inflammation of the same age from 25 to 44 years, the range of measured concentrations IS was: 50-92 PG/ml.

Based on these data it is possible to make generalizations with which you can define active during inflammation of the cervix or chronic ongoing inflammation in patients. Depending on the performed evaluation, patients are prescribed a different treatment. With proper evaluation of the condition of inflammation of the cervix and adequate treatment begins recovery of patients with astrapotherium inflammation, and long-protracted chronic inflammation.

The proposed method is illustrated by the following clinical examples.

Example 1. The patient To the Islands A.N., 35. Asked at reception with the purpose of periodic health examination. After clinical examination and verification of the diagnosis of the patient produced by the device for removal of native material from the surface of the cervix collection of the investigated product directly from the surface of the transformation zone with maximum fullness and atraumatic by prokachivanija on the surface of ectocervical working part in valickas coating vysokouglerodistogo material. The device is removed from the vagina, and menu position of the roller from horizontal to vertical, avoid touching the walls. Made removing the coating roller with tweezers and put it to full immersion in an Eppendorf tube filled with 1.0 ml 0,155M solution of sodium chloride. The tube is placed in a centrifuge vortex CM 70M-07, Elmi, is set to shake for 10 minutes, the Coating roller extracted from the tube with tweezers, with the release of excess fluid by compression against the wall of the tube. The analyzed sample in the amount of 100 μl using automatic single-channel pipette inserted in the hole of the tablet from set IL-ELISA-BEST"produced a sample by the method of solid-phase ELISA. The calculated concentration IL - 69,5 PG/ml, produced its initial values: normal, active and chronic inflammatory processes. Given the conclusion: chronic inflammatory process of the cervix.

Example 2. The patient Peninsula E.B., 33 years. Turned on medical consultation with a diagnosis of Complicated ectopia of the cervix on the background of chronic nonspecific cervicitis. After clinical examination and verification of the diagnosis of the patient produced by the filter paper applicator removal of native material directly from the surface of ectopia with maximum fullness and atraumatic. The collected material to complete immersion was placed in an Eppendorf tube filled 1,0 is l 0,155M solution of sodium chloride. The tube is placed in a centrifuge vortex CM 70M-07, Elmi, is set to shake for 10 minutes, the Paper is ejected from the tube with tweezers, the analyzed sample in the amount of 100 μl using automatic single-channel pipette inserted in the hole of the tablet from set IL-ELISA-BEST"produced a sample by the method of solid-phase ELISA. The calculated concentration IL - 85,4 PG/ml, produced its initial values: normal, active and chronic inflammatory processes. Given the conclusion: chronic inflammatory process. Assigned adequate treatment including immunomodulators locally in the form of candles at the first stage, further treatment according to the standard scheme.

Example 3. The patient And society L.A., 29 years. Turned on medical consultation with a diagnosis of Complicated ectopia cervical background bacterial nonspecific cervicitis. Reasonable cicatricial deformity of the cervix. After clinical examination and verification of the diagnosis of the patient produced by the filter paper applicator removal of native material directly from the surface of ectopia with maximum fullness and atraumatic. The collected material to complete immersion was placed in an Eppendorf tube filled with 1.0 ml 0,155M solution of sodium chloride. The tube is placed in a centrifuge vortex CM 70M-07, Elmi, the mouth of the established mode of shaking for 10 minutes The paper is extracted from the tube with tweezers, the sample material in the amount of 100 μl using automatic single-channel pipette inserted in the hole of the tablet from set IL-ELISA-BEST"produced a sample by the method of solid-phase ELISA. The calculated concentration IL - 138,6 PG/ml, produced its initial values: normal, active and chronic inflammatory processes. Given the conclusion: actively flowing inflammatory process, a pronounced immune response.

The method is tested in the clinic of obstetrics and gynecology pediatric Department of the Saratov state medical University-based antenatal clinic MMU "10 City clinical hospital" of Saratov and the Central research laboratory of the Saratov state medical University. Thus, the inventive method of assessing the activity of the local inflammation of the mucous of the cervix with background diseases, based on the determination of the level IS in the discharge from the surface of the nidus, allows you to:

on the basis of the obtained data to evaluate the activity of local inflammation;

on the basis of the results obtained to carry out timely and adequate pathogenetic treatment.

This method has the following advantages: high the Oh sensitivity, identifying concentrations up to 0.05 ng/ml; the ability to use the minimum volume of the material under investigation; the storage stability of all the ingredients necessary for carrying out ELISA to a year or more; the simplicity of the reaction; the presence of both instrumental and visual records; the possibility of automation of all stages of the reaction; relatively low cost diagnostic kits. Differences in achievable a result of the advantages of the claimed inventions.

For validation of the results of the evaluation of the activity of inflammation of the cervix was performed in parallel counting the number of cells in the field of view of the smear from the surface of ectocervix. Was produced by microscopy of stained smears by counting the number of leukocytes. For normal white blood cell count is up to 10 cells per field. 15-20-25 cells in field of view indicates asymptomatic flowing chronic inflammatory process, 30-35-40 cells in field of view - about the chronic inflammatory process, 45-50-55 cells in the field of view is about actively astrapotherium inflammatory process. These data coincided with the conclusions made by the present method is about the presence of chronic inflammation.

The increase in the number of leucocytes in a smear was characteristic of the work is actively proceeding acute% the sa and on the contrary, the reduction in the number of cells was characterized by the presence of a chronic inflammatory process.

Based on these test data confirmed the conclusion on the division of patients with active and chronic inflammation of the cervix, provided the concentrations of the cytokine received described method with a known set of reagents ELISA, with regard to the sampling at the initial stage and sample handling in the subsequent steps.

1. A method of evaluating the activity of local inflammation in the background cervical cancer, characterized by the fact that after clinical examination and verification of diagnosis patients produce with maximum fullness and noninvasive collection of the investigated product, summing device for removing native material to fix the outer cervix directly to the surface of the transformation zone of the cervix and of the pathological focus, not entering the device inside the cervical canal, then place the collected material to complete immersion in a tightly closed tube filled with 1.0 ml 0,155M solution of sodium chloride, the mixture is shaken in a centrifuge vortex for 10 minutes, examine the materials obtained by the method of enzyme-linked immunosorbent assay IFA tablets by using a set of reagents "Vector-best", spectrophotometric carry out the determination of the concentration of the cytokine interleukin-6 in samples, judged on the activity of local inflammation at concentrations of interleukin-6 in comparison with its normal concentration, equal to the value of 50 PG/ml in healthy individuals from the reference group, and if the value is above 50 to 92 PG/ml judged on the presence of a chronic inflammatory process, if the value is above 92 PG/ml judged on the presence of actively flowing inflammatory process and expressed immune response.

2. Device for removal of native material from the surface of the cervix, characterized in that it has a long holder in the form of a rod with length at least exceeding the length of the vagina, with the distal side of the rod at right angles to it posted by a work item in the form of a roller having a coating of removable vysokochastotnogo material developed absorbing surface, the proximal end of the rod serves as a manipulator handle, roller configured to move along the surface of the face side in the area of the external OS, with the possibility of rotation around its axis and changes its position from horizontal to vertical toggle manipulator handle, these elements have the following dimensions:
holder length - 200÷220 mm;
the length of the roll - 7÷10 mm;
the diameter of the roller - 4÷6 mm;
the thickness of the coating roller - 0,3 mm



 

Same patents:

FIELD: medicine.

SUBSTANCE: invention can be used for diagnostics of presence of destructive process in uterine appendages in case of localised peritonitis if gynecological genesis, and for selection of optimal treatment tactics. In order to realise the method content of C-reactive protein (CRP) in blood serum is determined by turbodimetric method, if values of C-reactive protein content are 130 mg/l and higher, purulent-destructive process in uterine appendages in case of localised peritonitis is diagnosed, if values of C-reactive protein content are lower than 130 mg/l diagnosed is purulent salpingitis in case of pelvioperitonitis.

EFFECT: application of method allows to detect presence of purulent-destructive process in uterine appendages in case of pelvioperitonitis in urgent way, which determines tactics of further treatment.

2 ex

FIELD: medicine.

SUBSTANCE: invention can be used for obtaining diagnostic and/or therapeutic agents, in particular antibodies, which specifically interact with proteins of cell surface of target cells. Claimed is method of screening phage display library and including it method of isolation of library element, which is specific partner of binding of target cell surface protein, and method of isolation of unknown cell surface protein, specifically interacting with library element. Method of screening phage display library according to invention includes contact of said library with cells of interest with further separation of cells, which bound with one or several elements of expression library, from non-bound elements by separation through organic phase, and differs by introduction of additional stage, which consists in carrying out before said separation of at least one stage of material washing, and ensures essential increase of method efficiency.

EFFECT: higher efficiency.

30 cl, 7 dwg, 6 ex

FIELD: medicine.

SUBSTANCE: invention refers to medicine, particularly to ophthalmology, can be used for prediction of progression of myopia acquired in schools in 10-14 and 15-17 year old children. Blood serum is analysed for cartilage glycoprotein-39 with the use of sandwich-type enzyme immunoassay. If its concentration is within 34.7-53.4 ng/ml in 10-14-year-old children and 22-56.3 ng/ml in 15-17-year-old children, a permanent course of myopia is predicted. The concentration 18.5-33.9 ng/ml in 10-14-year-old children and 53.7-69 ng/ml in 15-17-year-old children enables to predict a progressive course of myopia.

EFFECT: use of the invention improves accuracy of the prediction of clinical course.

4 ex

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to diagnostic techniques and concerns a diagnostic techniques technique for respiratory function of peripheral blood erythrocytes in pregnant women in herpes virus infection episode in the third trimester. The technique consists in determination of glutathione reductase and herpes virus antibody titre concentration by the enzyme immunoassay in peripheral blood in pregnant women suffered from a herpes virus infection episode. If glutathione reductase concentration is 8.36±0.137 E/g Hb (ref. - 7.82±0.185 E/g Hb), herpes virus antibody titre is 1:6400. If herpes virus antibody titre is increased to 1:12800, erythrocyte glutathione reductase concentration is decreased 4.48±0.22 E/g Hb.

EFFECT: technique is characterised by high sensitivity and allows predicting the development of impaired respiratory activity of erythrocytes in the pregnant women with the herpes virus infection episode.

FIELD: medicine.

SUBSTANCE: simultaneously two parametres are determined: for men - in ejaculate, and for women - in discharge of cervical canal, namely, slgA and lactoferrin. If level of secretory immunoglobulin A is 3.01±0.50 mcg/ml and lower and simultaneous level of lactoferrin is 6876±89 ng/ml and higher, gonococcus infection with systemic manifestations is diagnosed, if said condition is absent, localised gonorrhea is diagnosed.

EFFECT: application of claimed method allows carrying out differential diagnostics of various forms of gonococcus infection in case of its oligosymptomatic course.

3 ex, 2 tbl

FIELD: medicine.

SUBSTANCE: before and after treating chronic heart disease, modified LP(a) are determined as follows. Blood serum 0.6 ml is treated with 0.1% Triton X-100 0. 2 ml, incubated for 15 minutes at 20°C. Then 7% polyethylene glycol 6000 is added, incubated with the Sudan Black stain at 40°C for 1 h; it is followed with electrophoretic separation of LP in agarose gel in a cavity 4×20 mm. The decreasing level of modified LP(a) by 40% and more in comparison with the primitive level, treating chronic heart disease treatment is considered as effective.

EFFECT: higher accuracy of estimating clinical effectiveness of chronic heart disease.

1 tbl, 6 dwg, 3 ex

FIELD: medicine.

SUBSTANCE: there is offered a method to assess of enzyme's ability to the level of phosphorylation of polypeptide that implies a reaction of the analysed enzyme and a substratum presented with a biotin-conjugated fragment of 516 to 777 residues of a human insulin 1 receptor substratum (hIRS-1-p30), binding of the reaction product and immobilised streptavidin and detection of the level of phosphorylation by antibodies specific to the phosphorylated polypeptide residues.

EFFECT: according to the invention, the method allows identifying tyrosine and serine proteinases and can be taken as a basis of a test system for new modulators of their activity.

9 cl, 8 dwg, 4 ex

FIELD: medicine.

SUBSTANCE: activity of enzymes MAO A and MAO B is determined in tumor tissue in menopausal and reproductive patients with uterine body cancer in stage III. If the coefficient value is 4.48 - 6.90 maintaining remission for at least 12 months after treatment termination is forecasted in treated patients, and if the coefficient value is 18.70 - 50.27 recurrence of disease minimally in 7 months is predicted.

EFFECT: use of the method enables to determine efficacy of integrated treatment of patients with uterine body cancer in menopause and reproductive periods.

2 ex, 1 tbl

FIELD: chemistry.

SUBSTANCE: determination of content of compounds which can act as NO donors is based on the property of nitrite (NO2-), nitrosothiols (RSNO), dinitrosyl iron complexes (DNIC) to inhibit the catalase enzyme in the presence of halide ions, and their losing of this property under effect of certain factors which are different for each group of compounds. The method has sensitivity of up to 50 nM. Determination takes place in a neutral or almost neutral medium and does not require sample preparation.

EFFECT: use of the invention enables to quantitatively differentiate nitrite, nitrosothiols and DNIC.

7 tbl

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to pediatrics and can be used at treatment of hypotrophy in small children. That is ensured by evaluation of α1-antitrypsin and transferrin in blood serum. If the relation of α1-antitrypsin to transferrin is more than 0.58, the metabolic agents are introduced. If the relation is less than 0.58, the metabolic agents are not required.

EFFECT: method provides objectification of prescribing the metabolic agents with improving prognosis for a clinical course of said pathology and reduced time and price of treatment.

FIELD: medicine.

SUBSTANCE: invention can be used for obtaining diagnostic and/or therapeutic agents, in particular antibodies, which specifically interact with proteins of cell surface of target cells. Claimed is method of screening phage display library and including it method of isolation of library element, which is specific partner of binding of target cell surface protein, and method of isolation of unknown cell surface protein, specifically interacting with library element. Method of screening phage display library according to invention includes contact of said library with cells of interest with further separation of cells, which bound with one or several elements of expression library, from non-bound elements by separation through organic phase, and differs by introduction of additional stage, which consists in carrying out before said separation of at least one stage of material washing, and ensures essential increase of method efficiency.

EFFECT: higher efficiency.

30 cl, 7 dwg, 6 ex

FIELD: medicine.

SUBSTANCE: method includes application of complex basic and local drug therapy, as complex base drug therapy, used are Farmvir, Viferone-1, Zyrtec, Selzink, sorbent Lactofiltrim, enzyme Creon 10000 U, as local therapy used are Advantan-cream or ointment, Bepanthen or D-panthenol, or Topicream, moisturizing creams or oils, Farmvir being administered in dose 10-15 mg/kg of body weight, 7-day course, Viferone-1-150000 U - one suppository two times per day, 10-day course, after that one suppository every second day, 20-day course, Zyrtec - 2.5-5.0 mg/kg of body weight per day, one month course, Selzink (7 mg) - 0.5 tablet per one intake one time per day, two month course, Lactofiltrum - one tablet three times per day, 10-day course, Creon 10000 U, 7-10-day course, Advantan - one time per day until exacerbation of skin process is stopped, Bepanthen or D-panthenol, or Topicream - three-four week course, moisturising creams or oils for a long period of time.

EFFECT: method allows to increase therapeutic effect by elongating remission period and reduction of number of exacerbations in rehabilitation period in children.

7 tbl

FIELD: medicine.

SUBSTANCE: for diagnostics of early manifest congenital syphilis values of cellular, humoral link of immunity and phagocytosis in acute period of disease are determined. If values of relative number of CD8+ - subpopulation of T-lymphocytes are over 20.0% and phagocytic number of neutrophils is over 4.2 units with respect to control group, and if values of IRI (CD4+/CD8+) is lower than 2.9 and relative content of CD95+ - lymphocytes is lower than 19.6%, than in control group, early manifest congenital syphilis is diagnosed.

EFFECT: acceleration and increase of accuracy of manifest form of ECS diagnostics.

3 tbl, 2 ex

FIELD: medicine.

SUBSTANCE: invention represents plasmid DNA pD4spGBD enabling the expression of a recombinant antigen - protein LigA L. interrogans domain 4 in chimeric protein D4-GBD and 1,3-β-glucan-binding domain (GBD), and a method for making a based subunit engineered leptospirosis vaccine.

EFFECT: invention allows ensuring the development of an intensive immune response and high level of antibodies synthesis with no additional adjuvants.

6 cl, 1 dwg, 6 ex

FIELD: medicine.

SUBSTANCE: invention represents plasmid DNA pD5spGBD enabling the expression of a recombinant antigen - protein LigA L. interrogans domain 5 in chimeric protein D5-GBD and 1,3-β-glucan-binding domain (GBD), and a method for making a based subunit engineered leptospirosis vaccine.

EFFECT: invention allows ensuring the development of an intensive immune response and high level of antibodies synthesis with no additional adjuvants.

6 cl, 1 dwg, 6 ex

FIELD: medicine.

SUBSTANCE: immunological analysis and general blood test are carried out. In blood TNF-α, absolute content of CD4+lymphocytes, relative content of T-cytotoxic lymphocytes CD8+, results of spontaneous NBT-test are determined, in blood serum - general complementary activity, and Y index is calculated by formula. If Y value is less than 4.6, non-proliferative version of uterine myoma is predicted, if Y is higher than 6.8, proliferating version of uterine myoma is predicted; if Y is from 4.6 to 6.8 prognosis is indefinite, it is necessary to apply method of descriptive statistics (use of qualitative anamnestic and clinical criteria).

EFFECT: increased accuracy and informativity of diagnostics of morphological versions of uterine myoma in women of reproductive age.

3 ex

FIELD: medicine.

SUBSTANCE: in tear fluid by means of immunoblotting presence of antibodies IgM and IgG to specific cytomegalovirus antigens is determined.

EFFECT: optimisation of etiological deciphering of inflammatory diseases of eyes.

1 ex, 2 tbl

FIELD: medicine.

SUBSTANCE: invention relates to field of medicine, namely to obstetrics and neonatology. In order to diagnose intrauterine chlamydiosis infection in newborns morphological analysis of placenta tissues, obtained after delivery, is carried out. Semi-thin cuts of placenta are analysed, non-specific changes, characteristic of infectious placentitis, are detected in them. After that on slides with material applied are antibodies, peroxides is revealed by means of diaminobenzidine, put under cover glass, analysed in light microscope. If complexes peroxides-Chlamydia is present, Chlamydia infection in newborn is diagnosed.

EFFECT: method allows carrying out early diagnostics of intrauterine chlamydiosis infection in newborns.

5 dwg, 1 ex

FIELD: medicine.

SUBSTANCE: simultaneously two parametres are determined: for men - in ejaculate, and for women - in discharge of cervical canal, namely, slgA and lactoferrin. If level of secretory immunoglobulin A is 3.01±0.50 mcg/ml and lower and simultaneous level of lactoferrin is 6876±89 ng/ml and higher, gonococcus infection with systemic manifestations is diagnosed, if said condition is absent, localised gonorrhea is diagnosed.

EFFECT: application of claimed method allows carrying out differential diagnostics of various forms of gonococcus infection in case of its oligosymptomatic course.

3 ex, 2 tbl

FIELD: medicine.

SUBSTANCE: quantitative determination in vitro of basic fibroblast growth factor (bFGF) and human vascular endothelium growth factor (VEGF) in patient's blood serum is carried out by method of ELISA. If VEGF values are 185.66+33.5 pg/ml, bFGF 35.84±2.02 and more pg/ml, fast development and aggressive course of disease, bad response to carried out therapy are predicted. If VEGF values are 72.67±12.3 pg/ml, bFGF 34.06+2.59 pg/ml, slow development and benign course of disease are predicted.

EFFECT: application of invention increases accuracy of estimation of disease development and course, realises prognosis of bad response to carried out therapy in patients with chronic lympholeukemia.

2 dwg, 1 tbl, 3 ex

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to oncogynaecology. The ovaries are excluded from the radiation area. They are fixed during transposition. Pulsations of blood flow amplitude in the ovarian artery of a pedicle is monitored, and when observing the decrease in blood flow pulsation amplitude, further ovarian transposition is considered to be impossible and the ovaries are fixed in the peritoneum or the subcostal area. Blood flow pulsations in the ovarian artery of the pedicle is monitored with the use of an optically coupled isolator with an open optical infra-red channel integrated in a laparoscopic clamp used for the ovarian transposition; the presence and intensity of blood flow pulsations are indicated by a signal amplitude generated by a photodetector of the optically coupled isolator.

EFFECT: method allows avoiding disturbed circulation in the transposed ovaries that promotes preservation of their function after the surgical or combined intervention.

2 cl

Up!